MEDICARE: SEAN DICK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT-2044	WY

General Provider Information

NPI Number	:	1215520879
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SEAN DICK

Provider Business Mailing Address
First Line	:	4243 EAGLE PT
Second Line	:
City	:	NORTH ROYALTON
State	:	OH
Zip	:	44133-4172
Country	:	US
Telephone Number	:	330-410-3958
Fax Number	:

Provider Business Practice Location Address
First Line	:	23550 CENTER RIDGE RD STE 105
Second Line	:
City	:	WESTLAKE
State	:	OH
Zip	:	44145-3655
Country	:	US
Telephone Number	:	440-895-9770
Fax Number	:	440-895-9961

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/15/2021
Last Update Date	:	01/26/2024

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Directions to “ SEAN DICK ” Practice Location

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