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General NPI Number Information
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NPI Number | 1790658656
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Entity Type | Individual
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Provider Name | SEAN THOMAS SHERIDAN PTA
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Gender | Male
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Dates
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Enumeration Date | 09/26/2025
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Last Update Date | 09/26/2025
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Provider Practice Location Address
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Address Line | 3591 MURCHISON RD
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City | FAYETTEVILLE
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State | NC
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Zip | 28311-2821
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Country | US
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Telephone | 910-868-2002
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Fax | 910-868-2004
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Provider Business Mailing Address
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Address Line | PO BOX 187
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City | FAYETTEVILLE
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State | NC
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Zip | 28302-0187
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Country | US
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Telephone | 910-868-2002
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Fax | 910-868-2004
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | A7744
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License Number State | NC
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