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General NPI Number Information
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NPI Number | 1689607335
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Entity Type | Individual
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Provider Name | GARY D. SHERWOOD PT, MPT
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Gender | Male
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Dates
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Enumeration Date | 07/08/2006
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Last Update Date | 09/17/2013
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Provider Practice Location Address
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Address Line | 6160 TUTT BLVD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80923-3500
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Country | US
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Telephone | 719-596-0880
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Fax |
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Provider Business Mailing Address
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Address Line | 17875 BLACK SQUIRREL RD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80908-1501
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Country | US
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Telephone | 719-333-5572
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 9094
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License Number State | CO
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