Provider Demographics
NPI:1033498019
Name:STOCKWELL, SEAN CHRISTOPHER (DPT)
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:CHRISTOPHER
Last Name:STOCKWELL
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22120 MIDLAND DR STE 1
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66226-3554
Mailing Address - Country:US
Mailing Address - Phone:913-745-4064
Mailing Address - Fax:913-745-4352
Practice Address - Street 1:11340 NALL AVE
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1234
Practice Address - Country:US
Practice Address - Phone:913-257-5627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-09
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist