Doctor Name: | MR. SHERRY LYNNE WEATHERFORD |
NPI Number: | 1710026497 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMT |
License Number: | MA16326 |
Business Practice Address: | 9030 W Fort Island Trl Bldg 10 Crystal River, FL - 344292412 |
Business Phone Number: | 3522200167 |
Business Fax Number: | 3527954732 |
Mailing Address: | 6840 W Avocado St, CRYSTAL RIVER |
State: | FL |
Postal Code: | 344295680 |
Phone Number: | 3522200167 |
Fax Number: | 3527954732 |
NPI Enumeration Date: | 02/06/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | MA16326 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |