Provider Demographics
NPI:1609966191
Name:MAHONEY, SEAN PATRICK (DC)
Entity type:Individual
Prefix:DR
First Name:SEAN
Middle Name:PATRICK
Last Name:MAHONEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 LEDGEWOOD LN
Mailing Address - Street 2:
Mailing Address - City:HINESBURG
Mailing Address - State:VT
Mailing Address - Zip Code:05461-9544
Mailing Address - Country:US
Mailing Address - Phone:802-496-9206
Mailing Address - Fax:
Practice Address - Street 1:5031 MAIN ST
Practice Address - Street 2:
Practice Address - City:WAITSFIELD
Practice Address - State:VT
Practice Address - Zip Code:05673-7464
Practice Address - Country:US
Practice Address - Phone:802-496-9206
Practice Address - Fax:802-855-9220
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT006-0000779111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT5752OtherBC/BS
VT5752OtherBC/BS