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NPI Code Detail

MEDICARE: KIMBERLY SHARP PTA

MEDICARE: KIMBERLY SHARP PTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy Assistant06003036AIN

General Provider Information

NPI Number : 1295913168
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY SHARP PTA
Provider Business Mailing Address
First Line : 303 N HURSTBOURNE PKWY STE 200
Second Line :
City : LOUISVILLE
State : KY
Zip : 40222-5158
Country : US
Telephone Number : 502-412-5847
Fax Number :
Provider Business Practice Location Address
First Line : 303 N HURSTBOURNE PKWY STE 200
Second Line :
City : LOUISVILLE
State : KY
Zip : 40222-5158
Country : US
Telephone Number : 502-412-5847
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/04/2008
Last Update Date : 09/27/2012

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Directions to “ KIMBERLY SHARP PTA” Practice Location

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