Provider Demographics
NPI:1295123057
Name:FLEMING, SHERRY (PTA)
Entity type:Individual
Prefix:
First Name:SHERRY
Middle Name:
Last Name:FLEMING
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7883 BUCKLEY RD
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OH
Mailing Address - Zip Code:45133-9581
Mailing Address - Country:US
Mailing Address - Phone:937-393-8614
Mailing Address - Fax:937-393-8614
Practice Address - Street 1:7883 BUCKLEY RD
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OH
Practice Address - Zip Code:45133-9581
Practice Address - Country:US
Practice Address - Phone:937-393-8614
Practice Address - Fax:937-393-8614
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-02
Last Update Date:2015-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPTA06307225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant