Provider Demographics
NPI:1861670853
Name:SHARP, BRUCE V (BC-HIS, ACA)
Entity Type:Individual
Prefix:
First Name:BRUCE
Middle Name:V
Last Name:SHARP
Suffix:
Gender:M
Credentials:BC-HIS, ACA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 W 2100 S STE 120
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84115-1855
Mailing Address - Country:US
Mailing Address - Phone:801-484-3277
Mailing Address - Fax:
Practice Address - Street 1:140 W 2100 S STE 120
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84115-1855
Practice Address - Country:US
Practice Address - Phone:801-484-3277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-01
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1052324601237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist