Provider Demographics
NPI:1487799854
Name:SHARPE, SANDRA FARRELL (LPTA)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:FARRELL
Last Name:SHARPE
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 TWYCKENHAM DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-8518
Mailing Address - Country:US
Mailing Address - Phone:336-312-4101
Mailing Address - Fax:
Practice Address - Street 1:1313 CAROLINA ST STE 200
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-6002
Practice Address - Country:US
Practice Address - Phone:336-275-6380
Practice Address - Fax:336-275-6381
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3390225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant