Provider Demographics
NPI:1306920129
Name:POLCHINSKI, SHERRY ANN (DC)
Entity type:Individual
Prefix:DR
First Name:SHERRY
Middle Name:ANN
Last Name:POLCHINSKI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4327
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76540-4327
Mailing Address - Country:US
Mailing Address - Phone:254-634-6688
Mailing Address - Fax:254-634-9744
Practice Address - Street 1:412 E AVENUE G
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76541-6237
Practice Address - Country:US
Practice Address - Phone:254-634-6688
Practice Address - Fax:254-634-9744
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6102111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor