Provider Demographics
NPI:1801106083
Name:FOX, SHERRI FERGUSON (LMBT)
Entity type:Individual
Prefix:
First Name:SHERRI
Middle Name:FERGUSON
Last Name:FOX
Suffix:
Gender:F
Credentials:LMBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4285 HIGHWAY 24 27 E
Mailing Address - Street 2:STE. D
Mailing Address - City:MIDLAND
Mailing Address - State:NC
Mailing Address - Zip Code:28107-8501
Mailing Address - Country:US
Mailing Address - Phone:704-575-3025
Mailing Address - Fax:
Practice Address - Street 1:4285 HIGHWAY 24 27 E
Practice Address - Street 2:STE. D
Practice Address - City:MIDLAND
Practice Address - State:NC
Practice Address - Zip Code:28107-8501
Practice Address - Country:US
Practice Address - Phone:704-575-3025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-20
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC01787225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist