Provider Demographics
NPI:1538255419
Name:SEPIC, ERIN J (DC)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:J
Last Name:SEPIC
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1151 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VT
Mailing Address - Zip Code:05477-4472
Mailing Address - Country:US
Mailing Address - Phone:802-434-5437
Mailing Address - Fax:802-329-2163
Practice Address - Street 1:1151 W MAIN ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VT
Practice Address - Zip Code:05477-4472
Practice Address - Country:US
Practice Address - Phone:802-434-5437
Practice Address - Fax:802-329-2163
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT006-0001157111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT68834OtherBLUE CROSS PROVIDER ID
VT6602627OtherCIGNA PROVIDER ID