Provider Demographics
NPI:1427557701
Name:SHARP, DEBRA FILLER (MPT)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:FILLER
Last Name:SHARP
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:DEANNE
Other - Last Name:FILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9963 N MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:UT
Mailing Address - Zip Code:84003-9190
Mailing Address - Country:US
Mailing Address - Phone:801-380-1973
Mailing Address - Fax:
Practice Address - Street 1:3300 N RUNNING CREEK WAY STE 150
Practice Address - Street 2:
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-5563
Practice Address - Country:US
Practice Address - Phone:801-766-4244
Practice Address - Fax:801-766-4245
Is Sole Proprietor?:No
Enumeration Date:2018-02-01
Last Update Date:2018-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT312939-2401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist