Provider Demographics
NPI:1255575437
Name:SIZEMORE, SHERIDAN L (PT)
Entity type:Individual
Prefix:
First Name:SHERIDAN
Middle Name:L
Last Name:SIZEMORE
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:PO BOX 889
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:SC
Mailing Address - Zip Code:29721-0889
Mailing Address - Country:US
Mailing Address - Phone:803-313-7011
Mailing Address - Fax:803-313-7438
Practice Address - Street 1:509 HUBBARD DR
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:SC
Practice Address - Zip Code:29720-5604
Practice Address - Country:US
Practice Address - Phone:803-313-7011
Practice Address - Fax:803-313-7438
Is Sole Proprietor?:No
Enumeration Date:2009-05-01
Last Update Date:2009-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2160225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist