Healthcare Provider Details

I. General information

NPI: 1942500673
Provider Name (Legal Business Name): SEAN O'FLAHERTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2010
Last Update Date: 10/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7330 STAPLES MILL RD 192
RICHMOND VA
23228-4122
US

IV. Provider business mailing address

7330 STAPLES MILL RD 192
RICHMOND VA
23228-4122
US

V. Phone/Fax

Practice location:
  • Phone: 804-314-4809
  • Fax:
Mailing address:
  • Phone: 804-314-4809
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number0104557101
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License NumberCH9897
License Number StateFL

VIII. Authorized Official

Name: DR. SEAN O'FLAHERTY
Title or Position: OWNER
Credential: DC
Phone: 305-942-1288