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NPI Code Detail

MEDICARE: MRS. SHERRY LYNN DAVIS P.T.

MEDICARE: MRS. SHERRY LYNN DAVIS P.T.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistR1227MO

General Provider Information

NPI Number : 1316065063
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SHERRY LYNN DAVIS P.T.
Provider Business Mailing Address
First Line : 144 PCR 926
Second Line :
City : SAINT MARY
State : MO
Zip : 63673-9179
Country : US
Telephone Number : 573-547-7867
Fax Number :
Provider Business Practice Location Address
First Line : 434 N WEST ST
Second Line :
City : PERRYVILLE
State : MO
Zip : 63775-1359
Country : US
Telephone Number : 573-547-2530
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2007
Last Update Date : 07/08/2007

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