Provider Demographics
NPI:1841629771
Name:SHARPE, COURTNEY RYAN (DC)
Entity type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:RYAN
Last Name:SHARPE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 PINE ROCK TRL
Mailing Address - Street 2:
Mailing Address - City:SUGAR HILL
Mailing Address - State:GA
Mailing Address - Zip Code:30518-8124
Mailing Address - Country:US
Mailing Address - Phone:678-264-7482
Mailing Address - Fax:864-272-3987
Practice Address - Street 1:2950 BUFORD HWY
Practice Address - Street 2:#140
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-8249
Practice Address - Country:US
Practice Address - Phone:678-835-7242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-01
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR009243111NN1001X, 111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition