Healthcare Provider Details

I. General information

NPI: 1679755102
Provider Name (Legal Business Name): SHARP FAMILY CHIROPRACTIC,P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2007
Last Update Date: 11/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7610 E 49TH ST
KANSAS CITY MO
64129-2043
US

IV. Provider business mailing address

7610 E 49TH ST
KANSAS CITY MO
64129-2043
US

V. Phone/Fax

Practice location:
  • Phone: 816-560-3828
  • Fax: 816-921-4995
Mailing address:
  • Phone: 816-560-3828
  • Fax: 816-921-4995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number2005002603
License Number StateMO

VIII. Authorized Official

Name: DR. DONOVAN DOUGLAS SHARP
Title or Position: PRESIDENT
Credential: D.C.
Phone: 816-560-3828