Provider Demographics
NPI:1124234133
Name:CARTER, SHERYL L (PT)
Entity type:Individual
Prefix:
First Name:SHERYL
Middle Name:L
Last Name:CARTER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:SHERYL
Other - Middle Name:L
Other - Last Name:SANPHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1063 LOWER MAIN ST
Mailing Address - Street 2:SUITE C-221 PUUONE PLAZA
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-2038
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:81 MAKAWAO AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:MAKAWAO
Practice Address - State:HI
Practice Address - Zip Code:96768-8895
Practice Address - Country:US
Practice Address - Phone:808-572-2281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2014-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI22232251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0000251892OtherHMSA