Provider Demographics
NPI:1952921470
Name:SECHEN, GEORGE MATTHEW III
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:MATTHEW
Last Name:SECHEN
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 SALT ROCK RD # OX8
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:CT
Mailing Address - Zip Code:06350-5031
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1908 STADIUM RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32611-5700
Practice Address - Country:US
Practice Address - Phone:352-294-2925
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-24
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program