Provider Demographics
NPI:1083748255
Name:SHEERIN, SEAN P (PTA)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:P
Last Name:SHEERIN
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7018 SHAGBARK LN
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:WI
Mailing Address - Zip Code:53105
Mailing Address - Country:US
Mailing Address - Phone:262-758-0488
Mailing Address - Fax:
Practice Address - Street 1:8700 DURAND AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:STURTEVANT
Practice Address - State:WI
Practice Address - Zip Code:53177
Practice Address - Country:US
Practice Address - Phone:262-886-2599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1253-019OtherSTATE OF WISCONSIN PTA LI