Provider Demographics
NPI:1861777237
Name:CONLIN, SEAN MICHAEL (DC)
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:MICHAEL
Last Name:CONLIN
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 1:6015 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-5598
Mailing Address - Country:US
Mailing Address - Phone:319-277-9755
Mailing Address - Fax:
Practice Address - Street 1:6015 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:CEDAR FALLS
Practice Address - State:IA
Practice Address - Zip Code:50613-5598
Practice Address - Country:US
Practice Address - Phone:319-277-9755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-18
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007390111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA27-3542196OtherEIN