Provider Demographics
NPI:1982754222
Name:SHERRY, SCOTT CHARLES (DC)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:CHARLES
Last Name:SHERRY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1112COMMERCIAL ST.
Mailing Address - Street 2:P.O.BOX 92
Mailing Address - City:GLEN COVE
Mailing Address - State:ME
Mailing Address - Zip Code:04846-0092
Mailing Address - Country:US
Mailing Address - Phone:207-596-5523
Mailing Address - Fax:207-596-5655
Practice Address - Street 1:1112COMMERCIAL ST.
Practice Address - Street 2:
Practice Address - City:GLEN COVE
Practice Address - State:ME
Practice Address - Zip Code:04846-0092
Practice Address - Country:US
Practice Address - Phone:207-596-5523
Practice Address - Fax:207-596-5655
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR 1062111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor