Basic Information
| Provider Information | |||||||||
| NPI: | 1558799676 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MARONEY | ||||||||
| FirstName: | SEAN | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 269084 | ||||||||
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| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731269084 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6233988072 | ||||||||
| FaxNumber: | 6233988235 | ||||||||
| Practice Location | |||||||||
| Address1: | 29822 N CAVE CREEK RD STE 101 | ||||||||
| Address2: | |||||||||
| City: | CAVE CREEK | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853312015 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4807186856 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/29/2013 | ||||||||
| LastUpdateDate: | 05/10/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/10/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 10442 | AZ | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.