Individual
RICHARD SHERWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2003 SOVEREIGN DR, FORT WAYNE, IN 46815-7453
(260) 493-9796
Mailing address
2003 SOVEREIGN DR, FORT WAYNE, IN 46815-7453
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32001429A
IN
Other
Enumeration date
05/10/2011
Last updated
05/10/2011
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