Individual
DIANE VINCENT SHARP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
180 LEVELAND LN STE 1B, MODESTO, CA 95350-2254
(209) 604-2106
Mailing address
4016 BALLEN CT, MODESTO, CA 95356-9352
(209) 604-2106
Taxonomy
Speciality
Code
Description
License number
State
246ZA2600X
Medical Art Specialist/Technologist
Primary
—
—
Other
Enumeration date
07/28/2020
Last updated
07/28/2020
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