Individual
MR. SEAN P. ROACH SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A.ED, ATC/L, CAA
Contact information
Practice address
3 LAUREL ST, DANVERS, MA 01923-2731
(978) 578-1604
Mailing address
3 LAUREL ST, DANVERS, MA 01923-2731
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1401-AH-AT
MA
2255A2300X
Athletic Trainer
AH-1401-AT
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AH-1401-AT
ATC
MA
Enumeration date
06/07/2018
Last updated
06/07/2018
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