Most Relevant Information
Provider Data
| NPI Number: | 1003038597 |
| Provider Name: | REX LEE SHARP ATC |
| Entity Type: | Individual |
| Taxonomy Code: | 2255A2300X |
| Specialty: | Specialist/Technologist |
| License Number: | 114629 |
Most Important Dates
| Enumeration Date: | 05/03/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
100 MIZZOU ATHLETICS TRAINING COMPLEX
COLUMBIA
MD
652113030
Practice Location Phone/Fax
| Phone: | 5738822375 |
| Fax: | 5738840692 |
Provider Mailing Location
100 MIZZOU ATHLETICS TRAINING COMPLEX
COLUMBIA
MD
652113030
Provider Mailing Phone/Fax
| Phone: | 5738822375 |
| Fax: | 5738840692 |