MEDICARE: SEAN RILEY PT

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	3296	NH
2	225100000X	Physical Therapist	16585	MA

General Provider Information

NPI Number	:	1376729806
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SEAN RILEY PT

Provider Business Mailing Address
First Line	:	210 COMMERCE WAY
Second Line	:	SUITE 120
City	:	PORTSMOUTH
State	:	NH
Zip	:	03801-8200
Country	:	US
Telephone Number	:	603-427-8066
Fax Number	:	603-501-0495

Provider Business Practice Location Address
First Line	:	3 FERRY ST
Second Line	:	SUITE F
City	:	HAVERHILL
State	:	MA
Zip	:	01835-7442
Country	:	US
Telephone Number	:	978-469-9412
Fax Number	:

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

Provider Enumeration Date	:	01/15/2008
Last Update Date	:	04/19/2013

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Directions to “ SEAN RILEY PT” Practice Location

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