Doctor Name: | JACE EVAN SHARP |
NPI Number: | 1245662550 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DPT |
License Number: | 4722 |
Business Practice Address: | 1200 W Cherokee St Wagoner, OK - 744674624 |
Business Phone Number: | 9184851212 |
Business Fax Number: | 9184851335 |
Mailing Address: | 1200 W Cherokee St, WAGONER |
State: | OK |
Postal Code: | 744674624 |
Phone Number: | 9184851212 |
Fax Number: | 9184851335 |
NPI Enumeration Date: | 08/08/2013 |
NPI Last Update Date: | 01/04/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 4722 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |