Provider Demographics
NPI:1215223243
Name:SHARPE, LEIZL MORTEL (PT)
Entity Type:Individual
Prefix:MS
First Name:LEIZL
Middle Name:MORTEL
Last Name:SHARPE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 DILLSBORO RD
Mailing Address - Street 2:APT 2
Mailing Address - City:SYLVA
Mailing Address - State:NC
Mailing Address - Zip Code:28779-2556
Mailing Address - Country:US
Mailing Address - Phone:732-841-6798
Mailing Address - Fax:
Practice Address - Street 1:407 DILLSBORO RD
Practice Address - Street 2:APT 2
Practice Address - City:SYLVA
Practice Address - State:NC
Practice Address - Zip Code:28779-2556
Practice Address - Country:US
Practice Address - Phone:732-841-6798
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-28
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12469225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist