Provider Demographics
NPI:1285962753
Name:CHANDLER-EDGEMON, SHERRY DIANE (RRT)
Entity type:Individual
Prefix:
First Name:SHERRY
Middle Name:DIANE
Last Name:CHANDLER-EDGEMON
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:SHERRY
Other - Middle Name:DIANE
Other - Last Name:CHANDLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RRT
Mailing Address - Street 1:314 PINE ST
Mailing Address - Street 2:NA
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81503-2045
Mailing Address - Country:US
Mailing Address - Phone:970-986-8520
Mailing Address - Fax:970-986-8520
Practice Address - Street 1:2121 NORTH AVE
Practice Address - Street 2:NA
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-6428
Practice Address - Country:US
Practice Address - Phone:970-263-5062
Practice Address - Fax:970-244-7731
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-22
Last Update Date:2009-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25975227800000X
CO3219227800000X
CA103237227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified
No227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered