Individual
MR. SEAN CHRISTOPHER WAYNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC,LMT
Contact information
Practice address
181 WEST 600 SOUTH, BLDG 3A, OGDEN, UT 84404
(801) 628-3657
Mailing address
939 E 1510 N, NORTH OGDEN, UT 84404-7706
(801) 628-3657
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
6355752-4810
UT
225700000X
Massage Therapist
6355752-4701
UT
Other
Enumeration date
01/15/2010
Last updated
01/15/2010
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