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Individual

STERLING JEREL SHORES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
74 JOURNEY WAY, VALPARAISO, IN 46383-0078
(192) 554-3782
Mailing address
6654 W 158TH LN, LOWELL, IN 46356-4407
(219) 798-2597

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
31004741A
IN
174400000X
Specialist
OT00004190
WA
225X00000X
Occupational Therapist
Primary

Other

Enumeration date
03/26/2009
Last updated
12/08/2021
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