Provider Demographics
NPI:1548547920
Name:O'STEEN, SHAWN M (MS, ATC, CSCS)
Entity type:Individual
Prefix:MR
First Name:SHAWN
Middle Name:M
Last Name:O'STEEN
Suffix:
Gender:M
Credentials:MS, ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1714 SPRUCE HILLS DR
Mailing Address - Street 2:
Mailing Address - City:GLEN GARDNER
Mailing Address - State:NJ
Mailing Address - Zip Code:08826-3716
Mailing Address - Country:US
Mailing Address - Phone:732-991-5465
Mailing Address - Fax:
Practice Address - Street 1:1714 SPRUCE HILLS DR
Practice Address - Street 2:
Practice Address - City:GLEN GARDNER
Practice Address - State:NJ
Practice Address - Zip Code:08826-3716
Practice Address - Country:US
Practice Address - Phone:732-991-5465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-13
Last Update Date:2011-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MT001430002255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer