Provider Demographics
NPI:1740838911
Name:KLINCK, SEAN PATRICK (DPT)
Entity type:Individual
Prefix:DR
First Name:SEAN
Middle Name:PATRICK
Last Name:KLINCK
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 1:44 PHEASANT RUN LN
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:NY
Mailing Address - Zip Code:14086-1138
Mailing Address - Country:US
Mailing Address - Phone:716-548-5247
Mailing Address - Fax:
Practice Address - Street 1:44 PHEASANT RUN LN
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:NY
Practice Address - Zip Code:14086-1138
Practice Address - Country:US
Practice Address - Phone:716-548-5247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-29
Last Update Date:2022-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY039282225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist