Provider Demographics
NPI:1306376678
Name:MCLEAN, SEAN THOMAS (DC)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:THOMAS
Last Name:MCLEAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1104 ARNOLD AVE
Mailing Address - Street 2:
Mailing Address - City:POINT PLEASANT BORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08742-2311
Mailing Address - Country:US
Mailing Address - Phone:732-221-5718
Mailing Address - Fax:
Practice Address - Street 1:1104 ARNOLD AVE
Practice Address - Street 2:
Practice Address - City:POINT PLEASANT BORO
Practice Address - State:NJ
Practice Address - Zip Code:08742-2311
Practice Address - Country:US
Practice Address - Phone:732-221-5718
Practice Address - Fax:732-221-5718
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-19
Last Update Date:2017-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00725500111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor