Individual
NICHOLAS ENZINNA SHARP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
3001 IVY DR, NORTH NEWTON, KS 67117-8001
(316) 836-4800
Mailing address
304 OLD COLONY CT, NORTH NEWTON, KS 67117-8037
(434) 942-6955
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
11-05094
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11-05094
KANSAS STATE BOARD OF HEALING ARTS CERTIFICATE FOR PHYSICAL THERAPY
KS
Enumeration date
05/12/2015
Last updated
04/23/2018
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