Provider Demographics
NPI:1811950124
Name:SHEEHAN, THOMAS M (DC)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:M
Last Name:SHEEHAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:352 PARK ST STE 103
Mailing Address - Street 2:
Mailing Address - City:NORTH READING
Mailing Address - State:MA
Mailing Address - Zip Code:01864-2155
Mailing Address - Country:US
Mailing Address - Phone:978-664-1151
Mailing Address - Fax:
Practice Address - Street 1:352 PARK ST STE 103
Practice Address - Street 2:
Practice Address - City:NORTH READING
Practice Address - State:MA
Practice Address - Zip Code:01864-2155
Practice Address - Country:US
Practice Address - Phone:978-664-1151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-08
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1182111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1611313Medicaid
MAY35836OtherBCBS
MAT58416Medicare UPIN
MA1611313Medicaid