MEDICARE: DR. SEAN PATRICK SKINNER 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	011636	NY
2	390200000X	Student in an Organized Health Care Education/Training Program
3	111N00000X	Chiropractor	0104556699	VA
4	111N00000X	Chiropractor	3917	NC

General Provider Information

NPI Number	:	1982865747
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SEAN PATRICK SKINNER D.C.

Provider Business Mailing Address
First Line	:	4370 STARKEY RD.
Second Line	:	STE 2
City	:	ROANOKE
State	:	VA
Zip	:	24018
Country	:	US
Telephone Number	:	540-344-2000
Fax Number	:	540-782-3314

Provider Business Practice Location Address
First Line	:	4370 STARKEY RD.
Second Line	:	STE 2
City	:	ROANOKE
State	:	VA
Zip	:	24018
Country	:	US
Telephone Number	:	540-344-2000
Fax Number	:	540-782-3314

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

Provider Enumeration Date	:	06/24/2008
Last Update Date	:	05/27/2026

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