Provider Demographics
NPI:1043369317
Name:SHERWOOD, JOHN DEAN (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:DEAN
Last Name:SHERWOOD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:524 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:ELKO
Mailing Address - State:NV
Mailing Address - Zip Code:89801
Mailing Address - Country:US
Mailing Address - Phone:775-738-2225
Mailing Address - Fax:775-738-6886
Practice Address - Street 1:524 WALNUT ST
Practice Address - Street 2:
Practice Address - City:ELKO
Practice Address - State:NV
Practice Address - Zip Code:89801
Practice Address - Country:US
Practice Address - Phone:775-738-2225
Practice Address - Fax:775-738-6886
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB00388111N00000X
CA19602111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVVDCB388Medicare PIN