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General NPI Number Information
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NPI Number | 1841629771
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Entity Type | Individual
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Provider Name | COURTNEY RYAN SHARPE DC
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Gender | Male
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Dates
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Enumeration Date | 11/01/2013
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Last Update Date | 05/04/2017
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Provider Practice Location Address
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Address Line | 2950 BUFORD HWY #140
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City | CUMMING
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State | GA
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Zip | 30041-8249
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Country | US
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Telephone | 678-835-7242
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Fax |
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Provider Business Mailing Address
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Address Line | 540 PINE ROCK TRL
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City | SUGAR HILL
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State | GA
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Zip | 30518-8124
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Country | US
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Telephone | 678-264-7482
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Fax | 864-272-3987
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NN1001X
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Taxonomy Name | Nutrition Chiropractor
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License Number | CHIR009243
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License Number State | GA
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