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NPI Code Detail

MEDICARE: GARY D. SHERWOOD PT, MPT

MEDICARE:   GARY D. SHERWOOD  PT, MPT
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 Therapist9094CO

General Provider Information

NPI Number : 1689607335
Entity Type Code : Individual
Provider Name (Legal Business Name) : GARY D. SHERWOOD PT, MPT
Provider Business Mailing Address
First Line : 17875 BLACK SQUIRREL RD
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80908-1501
Country : US
Telephone Number : 719-333-5572
Fax Number :
Provider Business Practice Location Address
First Line : 6160 TUTT BLVD
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80923-3500
Country : US
Telephone Number : 719-596-0880
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2006
Last Update Date : 09/17/2013

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Directions to “ GARY D. SHERWOOD PT, MPT” Practice Location

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