Provider Demographics
NPI:1205361490
Name:TRAPP, SHARALYN (MSPT)
Entity Type:Individual
Prefix:
First Name:SHARALYN
Middle Name:
Last Name:TRAPP
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4596 DUANE DRIVE
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30519-7531
Mailing Address - Country:US
Mailing Address - Phone:404-944-1242
Mailing Address - Fax:
Practice Address - Street 1:4596 DUANE DRIVE
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30519-7531
Practice Address - Country:US
Practice Address - Phone:404-944-1242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-25
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT006419225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist