Provider Demographics
NPI:1619248176
Name:CONNOR, SHARON LEA (PT)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:LEA
Last Name:CONNOR
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 1:2984 E VIA BERLANGA
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:ARIZONA
Mailing Address - Zip Code:85706
Mailing Address - Country:UM
Mailing Address - Phone:520-207-8832
Mailing Address - Fax:
Practice Address - Street 1:1590 W COMMERCE CT
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85746-6015
Practice Address - Country:US
Practice Address - Phone:520-573-1443
Practice Address - Fax:520-573-1446
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-15
Last Update Date:2012-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4346225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist