Provider Demographics
NPI:1730274812
Name:MCGHEE, SHERRY W (PT)
Entity type:Individual
Prefix:MRS
First Name:SHERRY
Middle Name:W
Last Name:MCGHEE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1973 HENDON RD
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188-3046
Mailing Address - Country:US
Mailing Address - Phone:770-926-3928
Mailing Address - Fax:
Practice Address - Street 1:2015 VAUGHN RD NW
Practice Address - Street 2:SUITE 130
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-7801
Practice Address - Country:US
Practice Address - Phone:770-425-6661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPPT000715225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00560128CMedicaid
GA00560128BMedicaid