Provider Demographics
NPI:1174990964
Name:SHERWIN, LUKE (DPT)
Entity type:Individual
Prefix:
First Name:LUKE
Middle Name:
Last Name:SHERWIN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8817 N CEDAR LAKE RD
Mailing Address - Street 2:
Mailing Address - City:EDMORE
Mailing Address - State:MI
Mailing Address - Zip Code:48829-9788
Mailing Address - Country:US
Mailing Address - Phone:989-565-0227
Mailing Address - Fax:
Practice Address - Street 1:3922 W RIVER DR
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78410-5725
Practice Address - Country:US
Practice Address - Phone:361-767-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-27
Last Update Date:2015-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1265897225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist