Healthcare Provider Details

I. General information

NPI: 1598956674
Provider Name (Legal Business Name): ERICA SUE SHERMAN DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2007
Last Update Date: 11/29/2022
Certification Date: 11/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10126 MUTO RD
GOODRICH MI
48438-8803
US

IV. Provider business mailing address

10126 MUTO RD
GOODRICH MI
48438-8803
US

V. Phone/Fax

Practice location:
  • Phone: 989-233-0419
  • Fax:
Mailing address:
  • Phone: 989-233-0419
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501012905
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: