Provider Demographics
NPI:1225357817
Name:CARPENTER, SEAN (PT)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:CARPENTER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1721 KIRKS LN
Mailing Address - Street 2:
Mailing Address - City:DRESHER
Mailing Address - State:PA
Mailing Address - Zip Code:19025-1107
Mailing Address - Country:US
Mailing Address - Phone:215-867-9677
Mailing Address - Fax:215-839-3439
Practice Address - Street 1:801 EASTON RD STE 6
Practice Address - Street 2:
Practice Address - City:WILLOW GROVE
Practice Address - State:PA
Practice Address - Zip Code:19090-2024
Practice Address - Country:US
Practice Address - Phone:215-867-9677
Practice Address - Fax:215-839-3439
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-23
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT019519225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist