Sherri Southard

Individual provider Active NPI Massage Therapist · Millersport, OH

NPI 1104704030 · NPPES record last updated Aug 27, 2025

Key facts

NPI
1104704030
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
33.023293 (OH)
Practice address
10400 Lancaster Newark Rd NE
Millersport, OH 43046-8003
Phone
(740) 467-2486
Fax
(740) 467-2498
NPI assigned
Aug 27, 2025
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
33.023293OHMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Keller Family Chiropractic, LLC Current
since Sep 3, 2025
Accepting new patients

Locations

10400 Lancaster Newark Rd NE
Millersport, OH 43046
Phone (740) 467-2486

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 33.023293 OH Yes

Addresses

Primary practice location

10400 Lancaster Newark Rd NE
Millersport, OH 43046-8003

Mailing address

10400 Lancaster Newark Rd NE
Millersport, OH 43046-8003
Phone (740) 467-2486

Other providers in Millersport, OH

All providers in Millersport, OH · Massage Therapist in Ohio

Sources for this page

Verify at the official NPI Registry.