Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | 35086856 | OH |
Y | 213ES0000X | Sports Medicine | 35086856 | OH |
NPI | 1356567994 |
---|---|
Provider Name | Sean Thomas Mcgrath |
First Address | Poland, OH 44514-3359 |
Second Address | Poland, OH 44514-3359 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2007 |
Last Update Date | 12/01/2010 |