1518273291 NPI number — SHARON ADELE JUSTICE PT, DPT

Table of content: SHARON ADELE JUSTICE PT, DPT (NPI 1518273291)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518273291 NPI number — SHARON ADELE JUSTICE PT, DPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JUSTICE
Provider First Name:
SHARON
Provider Middle Name:
ADELE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PT, DPT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
JUSTICE
Provider Other First Name:
SHARON
Provider Other Middle Name:
THACKER
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
PT, DPT
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1518273291
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/19/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO DRAWER Z
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOT SPRINGS
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
24445
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-839-7336
Provider Business Mailing Address Fax Number:
540-839-2554

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9232 SAM SNEAD HIGHWAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOT SPRINGS
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24445
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-839-7336
Provider Business Practice Location Address Fax Number:
540-839-2554
Provider Enumeration Date:
08/19/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)