=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275631103
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SHERLEY MARGARET TENEFRANCIA PT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/21/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2536 W INDUSTRIAL PARK DR SUITE 10&11
-----------------------------------------------------
City | BLOOMINGTON
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 47404-2635
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 812-332-7529
-----------------------------------------------------
Fax | 812-339-7529
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1684 W HENNESSY ST
-----------------------------------------------------
City | BLOOMINGTON
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 47403-4645
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 812-331-2163
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 05006020A
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------