Provider Demographics
NPI:1447628250
Name:MCKEOWN, SEAN
Entity type:Individual
Prefix:MR
First Name:SEAN
Middle Name:
Last Name:MCKEOWN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 PADDEN RD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:MA
Mailing Address - Zip Code:02038-3638
Mailing Address - Country:US
Mailing Address - Phone:508-520-1370
Mailing Address - Fax:
Practice Address - Street 1:11 PADDEN RD
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:MA
Practice Address - Zip Code:02038-3638
Practice Address - Country:US
Practice Address - Phone:508-520-1370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-10
Last Update Date:2015-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI251225200000X
MA8991225200000X
MNA1895225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI251OtherPTA LICENSE
MA8991OtherPTA LICENSE
MNA1895OtherPTA LICENSE