Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist | 1966 | MS |
NPI | 1053764951 |
---|---|
Provider Name | Mr. Sean Michael Saucier |
First Address | Hattiesburg, MS 39401-3528 |
Second Address | Hattiesburg, MS 39401-3528 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2016 |
Last Update Date | 15/07/2016 |