Provider Demographics
NPI:1285002733
Name:FANCHER, SEAN K (DPT)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:K
Last Name:FANCHER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1060 PLAZA DR
Mailing Address - Street 2:# 200
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-2344
Mailing Address - Country:US
Mailing Address - Phone:303-233-1223
Mailing Address - Fax:205-876-8063
Practice Address - Street 1:19801 GOVERNORS HWY
Practice Address - Street 2:
Practice Address - City:FLOSSMOOR
Practice Address - State:IL
Practice Address - Zip Code:60422-4362
Practice Address - Country:US
Practice Address - Phone:708-647-1500
Practice Address - Fax:708-647-1800
Is Sole Proprietor?:No
Enumeration Date:2015-09-14
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0014926225100000X
IL070-021962225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist