Provider Demographics
NPI:1447668884
Name:SHARP, JOSHUA (ATC, LAT)
Entity type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:
Last Name:SHARP
Suffix:
Gender:M
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 NW 21ST AVE
Mailing Address - Street 2:APT: 127
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32609-3448
Mailing Address - Country:US
Mailing Address - Phone:765-748-8652
Mailing Address - Fax:
Practice Address - Street 1:1015 NW 21ST AVE
Practice Address - Street 2:APT 127
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32609-3448
Practice Address - Country:US
Practice Address - Phone:765-748-8652
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-29
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL3660390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program