Healthcare Provider Details

I. General information

NPI: 1356496202
Provider Name (Legal Business Name): JOHN HOWARD SHARPLESS D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 06/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1810 DOGWOOD DR
KOKOMO IN
46902-5737
US

IV. Provider business mailing address

1810 DOGWOOD DR
KOKOMO IN
46902-5737
US

V. Phone/Fax

Practice location:
  • Phone: 765-459-4575
  • Fax: 765-459-9415
Mailing address:
  • Phone: 765-459-4575
  • Fax: 765-459-9415

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number08000617A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: