Provider Demographics
NPI:1366880056
Name:MCMULLEN, SHEREE ALETA (LMT, PTA)
Entity type:Individual
Prefix:
First Name:SHEREE
Middle Name:ALETA
Last Name:MCMULLEN
Suffix:
Gender:F
Credentials:LMT, PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 234
Mailing Address - Street 2:
Mailing Address - City:UWCHLAND
Mailing Address - State:PA
Mailing Address - Zip Code:19480
Mailing Address - Country:US
Mailing Address - Phone:484-919-9217
Mailing Address - Fax:
Practice Address - Street 1:124 POTTSTOWN PIKE
Practice Address - Street 2:
Practice Address - City:CHESTER SPRINGS
Practice Address - State:PA
Practice Address - Zip Code:19425
Practice Address - Country:US
Practice Address - Phone:484-919-9217
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-05
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATE002216L225200000X
PAMSG002619225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant