Provider Demographics
NPI:1427137983
Name:SHERRY, JAE R (DPT)
Entity type:Individual
Prefix:DR
First Name:JAE
Middle Name:R
Last Name:SHERRY
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 BULLOCK ST
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02723
Mailing Address - Country:US
Mailing Address - Phone:774-644-5745
Mailing Address - Fax:508-567-0904
Practice Address - Street 1:425 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02721-3027
Practice Address - Country:US
Practice Address - Phone:774-644-5745
Practice Address - Fax:508-567-0904
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA15873225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist