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NPI Code Detail

MEDICARE: PHILIP MAURICE SHERRICK JR. OTR/L, CHT

MEDICARE: PHILIP MAURICE SHERRICK JR. OTR/L, CHT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational TherapistKS

General Provider Information

NPI Number : 1073712196
Entity Type Code : Individual
Provider Name (Legal Business Name) : PHILIP MAURICE SHERRICK JR. OTR/L, CHT
Provider Business Mailing Address
First Line : 11969 E KANSAS AVE
Second Line :
City : RILEY
State : KS
Zip : 66531-9666
Country : US
Telephone Number : 785-643-1517
Fax Number :
Provider Business Practice Location Address
First Line : 315 S SETH CHILD RD
Second Line :
City : MANHATTAN
State : KS
Zip : 66502-3003
Country : US
Telephone Number : 785-643-1517
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2007
Last Update Date : 07/18/2007

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