MEDICARE: DR. SEAN MICHAEL FALLON D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CH9002	FL

General Provider Information

NPI Number	:	1538143490
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SEAN MICHAEL FALLON D.C.

Provider Business Mailing Address
First Line	:	550 RADNOR DR
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34683-6033
Country	:	US
Telephone Number	:	727-267-4709
Fax Number	:	727-393-7922

Provider Business Practice Location Address
First Line	:	5288 SEMINOLE BLVD
Second Line	:
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33708-3356
Country	:	US
Telephone Number	:	727-391-4300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/05/2005
Last Update Date	:	11/28/2007

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