Provider Demographics
NPI:1427448703
Name:SHERWOOD CHIROPRACTIC
Entity type:Organization
Organization Name:SHERWOOD CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:G
Authorized Official - Last Name:SHERWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:208-249-9629
Mailing Address - Street 1:2128 N COLE RD
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-7311
Mailing Address - Country:US
Mailing Address - Phone:208-249-9629
Mailing Address - Fax:
Practice Address - Street 1:2128 N COLE RD
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-7311
Practice Address - Country:US
Practice Address - Phone:208-249-9629
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-26
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHIA-1621111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty