Healthcare Provider Details

I. General information

NPI: 1598536542
Provider Name (Legal Business Name): SHERLETA GAMBRELL LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2024
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2675 SAWBURY BLVD
COLUMBUS OH
43235-4582
US

IV. Provider business mailing address

7652 SAWMILL RD STE 188
DUBLIN OH
43016-9296
US

V. Phone/Fax

Practice location:
  • Phone: 833-649-3860
  • Fax:
Mailing address:
  • Phone: 833-649-3860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number33.025812
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: