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General NPI Number Information
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NPI Number | 1710374483
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Entity Type | Individual
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Provider Name | SEAN MATTHEW KIRKPATRICK DC
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Gender | Male
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Dates
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Enumeration Date | 04/21/2015
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Last Update Date | 04/21/2015
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Provider Practice Location Address
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Address Line | 2642 NEWTON AVE
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City | FORT MYERS
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State | FL
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Zip | 33901-5831
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Country | US
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Telephone | 239-334-7558
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Fax | 239-334-7558
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Provider Business Mailing Address
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Address Line | 2642 NEWTON AVE
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City | FORT MYERS
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State | FL
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Zip | 33901-5831
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Country | US
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Telephone | 239-334-7558
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Fax | 239-334-7558
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH 7192
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License Number State | FL
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