Provider Demographics
NPI:1134319627
Name:SHARP, JOEL ROBERT (PT)
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:ROBERT
Last Name:SHARP
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 SASSAFRAS LN
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:WV
Mailing Address - Zip Code:24739-8529
Mailing Address - Country:US
Mailing Address - Phone:304-922-8193
Mailing Address - Fax:
Practice Address - Street 1:175 W MONROE ST STE 167
Practice Address - Street 2:
Practice Address - City:WYTHEVILLE
Practice Address - State:VA
Practice Address - Zip Code:24382-2341
Practice Address - Country:US
Practice Address - Phone:304-922-8193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-31
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV004220225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist