Healthcare Provider Details

I. General information

NPI: 1255462867
Provider Name (Legal Business Name): SEAN ROBINS DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4825 RIVER RD N
KEIZER OR
97303-4537
US

IV. Provider business mailing address

4825 RIVER RD N
KEIZER OR
97303-4537
US

V. Phone/Fax

Practice location:
  • Phone: 503-390-1552
  • Fax: 503-393-3784
Mailing address:
  • Phone: 503-390-1552
  • Fax: 503-393-3784

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number273528
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: