Provider Demographics
NPI:1568933075
Name:LANGAN, SEAN (LAT, ATC)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:LANGAN
Suffix:
Gender:M
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1124 E VICTORY DR APT A
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31404-4171
Mailing Address - Country:US
Mailing Address - Phone:856-579-0173
Mailing Address - Fax:
Practice Address - Street 1:1124 E VICTORY DR APT A
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31404-4171
Practice Address - Country:US
Practice Address - Phone:856-579-0173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-09
Last Update Date:2018-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0035122255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer