MEDICARE: SHARP FAMILY CHIROPRACTIC,P.C.

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
1	111NR0400X	Rehabilitation Chiropractor	2005002603	MO

General Provider Information

NPI Number	:	1679755102
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHARP FAMILY CHIROPRACTIC,P.C.

Provider Business Mailing Address
First Line	:	7610 E 49TH ST
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64129-2043
Country	:	US
Telephone Number	:	816-560-3828
Fax Number	:	816-921-4995

Provider Business Practice Location Address
First Line	:	7610 E 49TH ST
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64129-2043
Country	:	US
Telephone Number	:	816-560-3828
Fax Number	:	816-921-4995

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DONOVAN DOUGLAS SHARP
Credential	:	D.C.
Telephone Number	:	816-560-3828

Provider Enumeration Date	:	11/27/2007
Last Update Date	:	11/27/2007

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