Provider Demographics
NPI:1548972615
Name:MUSSEN, SEAN MICHAEL (PT)
Entity type:Individual
Prefix:MR
First Name:SEAN
Middle Name:MICHAEL
Last Name:MUSSEN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 CORPORATE DR
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35242-2941
Mailing Address - Country:US
Mailing Address - Phone:425-238-3229
Mailing Address - Fax:
Practice Address - Street 1:1800 PRODUCE LN STE C
Practice Address - Street 2:
Practice Address - City:JOHNS ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29455-8375
Practice Address - Country:US
Practice Address - Phone:843-375-9796
Practice Address - Fax:843-376-9808
Is Sole Proprietor?:No
Enumeration Date:2022-12-20
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH5093225100000X
SCCP046346T225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH5093OtherOFFICE OF LICENSED ALLIED HEALTH PROFESSIONALS