Provider Demographics
NPI:1356016158
Name:SHEAHAN, BARBARA ANN (PT)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:ANN
Last Name:SHEAHAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10027 LAKESIDE DR
Mailing Address - Street 2:
Mailing Address - City:PERRINTON
Mailing Address - State:MI
Mailing Address - Zip Code:48871-9645
Mailing Address - Country:US
Mailing Address - Phone:989-388-1349
Mailing Address - Fax:
Practice Address - Street 1:2425 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:MI
Practice Address - Zip Code:48838-8259
Practice Address - Country:US
Practice Address - Phone:616-225-2325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-12
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501010492225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist