Individual
SEAN MCCUMISKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
4229 LAFAYETTE CENTER DR, 1250, CHANTILLY, VA 20151-1261
(703) 263-2020
Mailing address
6010 ROCKTON CT, CENTREVILLE, VA 20121-3080
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306602017
VA
Other
Enumeration date
12/08/2011
Last updated
12/08/2011
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