Provider Demographics
NPI:1134468572
Name:CARVER, SEAN MICHAEL (LAT, ATC, NASM-PES)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:MICHAEL
Last Name:CARVER
Suffix:
Gender:M
Credentials:LAT, ATC, NASM-PES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3611 HORSESHOE PIKE
Mailing Address - Street 2:
Mailing Address - City:HONEY BROOK
Mailing Address - State:PA
Mailing Address - Zip Code:19344-8650
Mailing Address - Country:US
Mailing Address - Phone:484-798-4008
Mailing Address - Fax:
Practice Address - Street 1:1871 OLD MAIN DR
Practice Address - Street 2:
Practice Address - City:SHIPPENSBURG
Practice Address - State:PA
Practice Address - Zip Code:17257-2200
Practice Address - Country:US
Practice Address - Phone:717-477-1749
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-05
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0052032255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer