=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477617975
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SHERRY L WALKER D.C.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/20/2006
-----------------------------------------------------
Last Update Date | 12/22/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 228 PAPERJACK DR SUITE 8
-----------------------------------------------------
City | NEW RICHMOND
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 54017
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 715-246-3500
-----------------------------------------------------
Fax | 715-246-9200
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 228 PAPERJACK DR. SUITE 8
-----------------------------------------------------
City | NEW RICHMOND
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 54017
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 715-246-3500
-----------------------------------------------------
Fax | 715-246-9200
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 1713-012
-----------------------------------------------------
License Number State | WI
-----------------------------------------------------