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General NPI Number Information
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NPI Number | 1588745616
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Entity Type | Organization
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Legal Business Name | SHARP PROFORMANCE LLC.
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2041 RIVER RD # A
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City | LOUISVILLE
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State | KY
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Zip | 40206-1006
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Country | US
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Telephone | 502-895-4447
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Fax | 502-895-4044
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Provider Business Mailing Address
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Address Line | 2041 A RIVER ROAD
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City | LOUISVILLE
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State | KY
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Zip | 40206-1006
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Country | US
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Telephone | 502-895-4447
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Fax | 502-895-4044
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DOUGLAS J SHARP
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Credential | D.C.
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Telephone | 502-895-4447
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 4406
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License Number State | KY
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