Healthcare Provider Details

I. General information

NPI: 1922877810
Provider Name (Legal Business Name): MICHAEL SHERRILL DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/20/2023
Last Update Date: 01/16/2024
Certification Date: 01/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

919 E MAIN ST
PARK HILLS MO
63601-2717
US

IV. Provider business mailing address

PO BOX 401
PARK HILLS MO
63601-0401
US

V. Phone/Fax

Practice location:
  • Phone: 573-327-4067
  • Fax:
Mailing address:
  • Phone: 573-631-8709
  • Fax: 636-479-1088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2023049803
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: