Individual
MR. SEAN MICHAEL ROACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD, PT, DPT, ATC
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
04555
OR
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8632629771
STATE OF OREGON
OR
Enumeration date
01/17/2006
Last updated
06/07/2021
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