Provider Demographics
NPI:1780945352
Name:SEGULIN, SHAWN STEVEN (LPT)
Entity type:Individual
Prefix:MR
First Name:SHAWN
Middle Name:STEVEN
Last Name:SEGULIN
Suffix:
Gender:M
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:CHAGRIN FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44022-3026
Mailing Address - Country:US
Mailing Address - Phone:440-247-2644
Mailing Address - Fax:440-247-0131
Practice Address - Street 1:34 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:CHAGRIN FALLS
Practice Address - State:OH
Practice Address - Zip Code:44022-3026
Practice Address - Country:US
Practice Address - Phone:440-247-2644
Practice Address - Fax:440-247-0131
Is Sole Proprietor?:No
Enumeration Date:2012-05-31
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH09269225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist