MEDICARE: DR. SHERRA BRYANT CONDE D.C.

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
1	111N00000X	Chiropractor	038011621	IL

General Provider Information

NPI Number	:	1598097172
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHERRA BRYANT CONDE D.C.

Provider Business Mailing Address
First Line	:	PO BOX 719
Second Line	:
City	:	MANCHESTER
State	:	GA
Zip	:	31816-0719
Country	:	US
Telephone Number	:	706-846-2787
Fax Number	:

Provider Business Practice Location Address
First Line	:	40 EASTBROOK BND
Second Line	:
City	:	PEACHTREE CITY
State	:	GA
Zip	:	30269-1567
Country	:	US
Telephone Number	:	305-834-9839
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/05/2010
Last Update Date	:	10/22/2012

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