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NPI Code Detail

MEDICARE: DR. SEAN THOMAS WHITE DPT, OCS, CMDT, COMT

MEDICARE:  DR. SEAN THOMAS WHITE  DPT, OCS, CMDT, COMT
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
1225100000XPhysical Therapist05007643AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000382035OTHERINANTHEM BLUE CROSS

General Provider Information

NPI Number : 1083722268
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SEAN THOMAS WHITE DPT, OCS, CMDT, COMT
Provider Business Mailing Address
First Line : 169 N 200 E
Second Line :
City : COLUMBIA CITY
State : IN
Zip : 46725-8895
Country : US
Telephone Number : 260-244-5133
Fax Number : 260-244-5134
Provider Business Practice Location Address
First Line : 169 N 200 E
Second Line :
City : COLUMBIA CITY
State : IN
Zip : 46725-8895
Country : US
Telephone Number : 260-244-5133
Fax Number : 260-255-5134
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2006
Last Update Date : 10/06/2025

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Directions to “ DR. SEAN THOMAS WHITE DPT, OCS, CMDT, COMT” Practice Location

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