MEDICARE: MR. SEAN M EARLY MPT

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	1129	NV

General Provider Information

NPI Number	:	1366547028
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SEAN M EARLY MPT

Provider Business Mailing Address
First Line	:	8235 S EASTERN AVE STE 150
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-2507
Country	:	US
Telephone Number	:	702-330-3073
Fax Number	:	702-509-5386

Provider Business Practice Location Address
First Line	:	8235 S EASTERN AVE STE 150
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-2507
Country	:	US
Telephone Number	:	702-330-3073
Fax Number	:	702-509-5386

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

Provider Enumeration Date	:	09/14/2006
Last Update Date	:	04/09/2024

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