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General NPI Number Information
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NPI Number | 1467683409
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Entity Type | Individual
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Provider Name | SHERI BURELL NISHIMURA OT, LMT
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Gender | Female
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Dates
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Enumeration Date | 08/06/2009
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Last Update Date | 04/30/2024
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Provider Practice Location Address
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Address Line | 2357 WARM SPRINGS RD STE 120
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City | COLUMBUS
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State | GA
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Zip | 31904-5690
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Country | US
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Telephone | 706-325-2583
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Fax |
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Provider Business Mailing Address
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Address Line | 2415 CANTER DR
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City | PHENIX CITY
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State | AL
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Zip | 36867-7477
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Country | US
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Telephone | 706-992-5868
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 2346
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT013598
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License Number State | GA
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