Healthcare Provider Details

I. General information

NPI: 1790779346
Provider Name (Legal Business Name): SHERRI LOVE HEALY ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 09/08/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 NICHOLS ST
ANSONIA CT
06401-1107
US

IV. Provider business mailing address

8 NICHOLS ST
ANSONIA CT
06401-1107
US

V. Phone/Fax

Practice location:
  • Phone: 203-732-3957
  • Fax:
Mailing address:
  • Phone: 203-732-3957
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: