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General NPI Number Information
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NPI Number | 1457860181
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Entity Type | Individual
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Provider Name | SEAN DAVID BEARD PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 09/26/2017
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Last Update Date | 09/26/2017
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Provider Practice Location Address
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Address Line | 505 WILLIAM THOMASON BYU
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City | LEITCHFIELD
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State | KY
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Zip | 42754-1419
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Country | US
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Telephone | 270-259-3676
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Fax |
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Provider Business Mailing Address
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Address Line | 9925 MORGANS LN SE
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City | ELIZABETH
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State | IN
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Zip | 47117-7809
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Country | US
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Telephone |
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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 | 006638
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License Number State | KY
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