Sean Blum, DPT

Individual provider Active NPI Physical Therapist · Fond Du Lac, WI

NPI 1407765332 · NPPES record last updated Sep 4, 2026

Key facts

NPI
1407765332
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
Practice address
N8679 Lakeshore Dr
Fond Du Lac, WI 54937-1727
Phone
(630) 456-8698
NPI assigned
Sep 4, 2026
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X WI Yes

Addresses

Primary practice location

N8679 Lakeshore Dr
Fond Du Lac, WI 54937-1727

Mailing address

N8679 Lakeshore Dr
Fond Du Lac, WI 54937-1727
Phone (630) 456-8698

Other providers in Fond Du Lac, WI

All providers in Fond Du Lac, WI · Physical Therapist in Wisconsin

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 4, 2026. Information in NPPES is self-reported and not verified by CMS.
  • NUCC Health Care Provider Taxonomy: specialty names.

Verify at the official NPI Registry.