Provider Demographics
NPI:1730240342
Name:TOLLENAAR, SHERYL LYNN (DC)
Entity type:Individual
Prefix:
First Name:SHERYL
Middle Name:LYNN
Last Name:TOLLENAAR
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3824 CEDAR SPRINGS RD
Mailing Address - Street 2:#256
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-4136
Mailing Address - Country:US
Mailing Address - Phone:214-636-6918
Mailing Address - Fax:
Practice Address - Street 1:6901 SNIDER PLZ
Practice Address - Street 2:SUITE #140
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75205-5648
Practice Address - Country:US
Practice Address - Phone:214-636-6918
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2017-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC6342111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U51742Medicare UPIN