Provider Demographics
NPI:1427238245
Name:MCFADDEN, SHARON (PT)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:MCFADDEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1251 E DOROTHY LN
Mailing Address - Street 2:
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45419-2106
Mailing Address - Country:US
Mailing Address - Phone:937-298-1111
Mailing Address - Fax:937-298-7210
Practice Address - Street 1:8630 WASHINGTON CHURCH RD
Practice Address - Street 2:
Practice Address - City:MIAMISBURG
Practice Address - State:OH
Practice Address - Zip Code:45342-3795
Practice Address - Country:US
Practice Address - Phone:937-298-1111
Practice Address - Fax:937-298-7210
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-08
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT.009796-1YR225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist