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General NPI Number Information
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NPI Number | 1215520879
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Entity Type | Individual
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Provider Name | SEAN DICK
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Gender | Male
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Dates
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Enumeration Date | 02/15/2021
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Last Update Date | 01/26/2024
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Provider Practice Location Address
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Address Line | 23550 CENTER RIDGE RD STE 105
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City | WESTLAKE
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State | OH
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Zip | 44145-3655
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Country | US
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Telephone | 440-895-9770
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Fax | 440-895-9961
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Provider Business Mailing Address
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Address Line | 4243 EAGLE PT
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City | NORTH ROYALTON
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State | OH
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Zip | 44133-4172
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Country | US
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Telephone | 330-410-3958
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT-2044
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License Number State | WY
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