Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251S0007X | Physical Therapist - Sports | 06297 | OH |
NPI | 1336355635 |
---|---|
Provider Name | Miss Cassy Ryanne Sharp |
First Address | Louisville, OH 44641-9533 |
Second Address | Louisville, OH 44641-9533 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2007 |
Last Update Date | 08/07/2007 |