Provider Demographics
NPI:1891880993
Name:AHONEN, SEAN BRADLEY (ATC)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:BRADLEY
Last Name:AHONEN
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1909 COLORADO CT
Mailing Address - Street 2:
Mailing Address - City:FOLEY
Mailing Address - State:AL
Mailing Address - Zip Code:36535-3480
Mailing Address - Country:US
Mailing Address - Phone:251-955-6705
Mailing Address - Fax:251-943-5190
Practice Address - Street 1:FOLEY HIGH SCHOOL
Practice Address - Street 2:1 PRIDE PLACE
Practice Address - City:FOLEY
Practice Address - State:AL
Practice Address - Zip Code:36535
Practice Address - Country:US
Practice Address - Phone:251-943-5172
Practice Address - Fax:251-943-5190
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL9042255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer