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General NPI Number Information
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NPI Number | 1942500673
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Entity Type | Organization
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Legal Business Name | SEAN O'FLAHERTY
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Dates
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Enumeration Date | 10/28/2010
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Last Update Date | 10/16/2013
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Provider Practice Location Address
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Address Line | 7330 STAPLES MILL RD 192
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City | RICHMOND
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State | VA
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Zip | 23228-4122
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Country | US
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Telephone | 804-314-4809
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Fax |
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Provider Business Mailing Address
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Address Line | 7330 STAPLES MILL RD 192
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City | RICHMOND
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State | VA
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Zip | 23228-4122
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Country | US
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Telephone | 804-314-4809
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SEAN O'FLAHERTY
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Credential | DC
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Telephone | 305-942-1288
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number | CH9897
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 0104557101
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License Number State | VA
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