Provider Demographics
NPI:1336763127
Name:SHARP, RANDYE N (PT-DPT)
Entity Type:Individual
Prefix:
First Name:RANDYE
Middle Name:N
Last Name:SHARP
Suffix:
Gender:F
Credentials:PT-DPT
Other - Prefix:
Other - First Name:RANDYE
Other - Middle Name:N
Other - Last Name:KNOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT-DPT
Mailing Address - Street 1:224 S BRADY ST STE 109
Mailing Address - Street 2:
Mailing Address - City:CLAREMORE
Mailing Address - State:OK
Mailing Address - Zip Code:74017-5085
Mailing Address - Country:US
Mailing Address - Phone:918-923-4700
Mailing Address - Fax:
Practice Address - Street 1:224 S BRADY ST STE 109
Practice Address - Street 2:
Practice Address - City:CLAREMORE
Practice Address - State:OK
Practice Address - Zip Code:74017-5085
Practice Address - Country:US
Practice Address - Phone:918-923-4700
Practice Address - Fax:918-923-4701
Is Sole Proprietor?:No
Enumeration Date:2020-06-08
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5814225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist