MEDICARE: SHERWOOD GROUP, INC

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	225X00000X	Occupational Therapist
2	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1710190806
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHERWOOD GROUP, INC

Provider Business Mailing Address
First Line	:	509 FORT ST STE B
Second Line	:
City	:	BUFFALO
State	:	WY
Zip	:	82834-1807
Country	:	US
Telephone Number	:	307-684-8623
Fax Number	:	307-684-8623

Provider Business Practice Location Address
First Line	:	509 FORT ST STE B
Second Line	:
City	:	BUFFALO
State	:	WY
Zip	:	82834-1807
Country	:	US
Telephone Number	:	307-684-8623
Fax Number	:	307-684-8623

Authorized Official
Title or Position	:	OWNER
Name	:	KENT SHERWOOD
Credential	:	MS PT
Telephone Number	:	307-684-8623

Provider Enumeration Date	:	05/07/2007
Last Update Date	:	12/27/2007

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