Provider Demographics
NPI:1215344130
Name:WILTSHIRE, SHERRY ANN (RTT, CMD)
Entity type:Individual
Prefix:
First Name:SHERRY
Middle Name:ANN
Last Name:WILTSHIRE
Suffix:
Gender:F
Credentials:RTT, CMD
Other - Prefix:
Other - First Name:SHERRY
Other - Middle Name:ANN
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RTT
Mailing Address - Street 1:PO BOX 4000
Mailing Address - Street 2:LAMONT & VETERANS WAY
Mailing Address - City:MOUNTAIN HOME
Mailing Address - State:TN
Mailing Address - Zip Code:37684
Mailing Address - Country:US
Mailing Address - Phone:423-926-1171
Mailing Address - Fax:
Practice Address - Street 1:LAMONT STREET & VETERANS WAY
Practice Address - Street 2:
Practice Address - City:MOUNTAIN HOME
Practice Address - State:TN
Practice Address - Zip Code:37684
Practice Address - Country:US
Practice Address - Phone:423-926-1171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-14
Last Update Date:2014-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471R0002XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiation Therapy