Individual
MR. SHERRY LYNNE WEATHERFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
9030 W FORT ISLAND TRL BLDG 10, CRYSTAL RIVER, FL 34429-2412
(352) 220-0167
(352) 795-4732
Mailing address
6840 W AVOCADO ST, CRYSTAL RIVER, FL 34429-5680
(352) 220-0167
(352) 795-4732
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA16326
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C7345
PIN BLUECROSS BLUE SHILED
FL
Enumeration date
02/06/2007
Last updated
07/08/2007
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