Provider Demographics
NPI:1871547000
Name:SPENCER-BROWN, SHERRY (PT)
Entity type:Individual
Prefix:MRS
First Name:SHERRY
Middle Name:
Last Name:SPENCER-BROWN
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 1:2 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:ASSONET
Mailing Address - State:MA
Mailing Address - Zip Code:02702-1310
Mailing Address - Country:US
Mailing Address - Phone:508-947-5195
Mailing Address - Fax:
Practice Address - Street 1:31 W GROVE ST
Practice Address - Street 2:
Practice Address - City:MIDDLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02346-1806
Practice Address - Country:US
Practice Address - Phone:508-947-5195
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3467225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY66135OtherPHYSICAL THERAPIST
MAY66135OtherPHYSICAL THERAPIST