Provider Demographics
NPI:1164241691
Name:SHERROW, SAMUEL (CSW)
Entity type:Individual
Prefix:
First Name:SAMUEL
Middle Name:
Last Name:SHERROW
Suffix:
Gender:M
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 W 900 N
Mailing Address - Street 2:
Mailing Address - City:SPRINGVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84663-1097
Mailing Address - Country:US
Mailing Address - Phone:801-404-7570
Mailing Address - Fax:
Practice Address - Street 1:1385 S STATE ST
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84115-5582
Practice Address - Country:US
Practice Address - Phone:801-404-7570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-10
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare