Healthcare Provider Details

I. General information

NPI: 1891119459
Provider Name (Legal Business Name): MAHONEY FAMILY CHIROPRACTIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2014
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5031 MAIN ST
WAITSFIELD VT
05673-7464
US

IV. Provider business mailing address

324 LEDGEWOOD LN
HINESBURG VT
05461-9544
US

V. Phone/Fax

Practice location:
  • Phone: 802-496-9206
  • Fax: 802-855-9220
Mailing address:
  • Phone: 802-496-9206
  • Fax: 802-855-9220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. SEAN P MAHONEY
Title or Position: OWNER
Credential: D.C.
Phone: 802-496-9206