Provider Demographics
NPI:1699086553
Name:SHERROD CHIROPRACTIC, PLC
Entity type:Organization
Organization Name:SHERROD CHIROPRACTIC, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:A
Authorized Official - Last Name:SHERROD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:870-934-8481
Mailing Address - Street 1:2512 ALEXANDER DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-7175
Mailing Address - Country:US
Mailing Address - Phone:870-934-8481
Mailing Address - Fax:870-934-8469
Practice Address - Street 1:2512 ALEXANDER DR
Practice Address - Street 2:SUITE B
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-7175
Practice Address - Country:US
Practice Address - Phone:870-934-8481
Practice Address - Fax:870-934-8469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-25
Last Update Date:2010-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR15710111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty