Provider Demographics
NPI:1336452309
Name:MACEACHRON, SHARON ANN (MSPT)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:ANN
Last Name:MACEACHRON
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1041 N HUNT CLUB DR
Mailing Address - Street 2:
Mailing Address - City:HERNANDO
Mailing Address - State:FL
Mailing Address - Zip Code:34442-6372
Mailing Address - Country:US
Mailing Address - Phone:781-507-6481
Mailing Address - Fax:
Practice Address - Street 1:1041 N HUNT CLUB DR
Practice Address - Street 2:
Practice Address - City:HERNANDO
Practice Address - State:FL
Practice Address - Zip Code:34442-6372
Practice Address - Country:US
Practice Address - Phone:781-507-6481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-20
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL38951225100000X
MA17910390200000X
PAPT016072390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist