Provider Demographics
NPI:1740815984
Name:QUE, SHERRY GEIL SACLAYAN
Entity type:Individual
Prefix:MS
First Name:SHERRY GEIL
Middle Name:SACLAYAN
Last Name:QUE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 CREASON CT UNIT 206
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-6139
Mailing Address - Country:US
Mailing Address - Phone:502-415-4103
Mailing Address - Fax:
Practice Address - Street 1:7225 NOVAS LNDG
Practice Address - Street 2:
Practice Address - City:SELLERSBURG
Practice Address - State:IN
Practice Address - Zip Code:47172-1790
Practice Address - Country:US
Practice Address - Phone:812-748-7433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-09
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05013679A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist