Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 11675-24 | WI |
N | 225100000X | Physical Therapist | 8451 | AZ |
N | 2251S0007X | Physical Therapist - Sports | ||
N | 2251X0800X | Physical Therapist - Orthopedic |
NPI | 1013159649 |
---|---|
Provider Name | Jeremy F Sherman |
First Address | Edgar, WI 54426-9292 |
Second Address | Edgar, WI 54426-9292 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2009 |
Last Update Date | 22/09/2011 |