Provider Demographics
NPI:1932440294
Name:OLIVER, SHERRY INEZ (PT)
Entity type:Individual
Prefix:
First Name:SHERRY
Middle Name:INEZ
Last Name:OLIVER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:614 MABRY HOOD RD STE 301
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37932-2669
Mailing Address - Country:US
Mailing Address - Phone:865-474-8413
Mailing Address - Fax:855-232-8604
Practice Address - Street 1:614 MABRY HOOD RD STE 301
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37932-2669
Practice Address - Country:US
Practice Address - Phone:865-474-8413
Practice Address - Fax:855-232-8604
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-12
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4012225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist