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General NPI Number Information
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NPI Number | 1982865747
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Entity Type | Individual
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Provider Name | SEAN PATRICK SKINNER D.C.
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Gender | Male
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Dates
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Enumeration Date | 06/24/2008
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Last Update Date | 06/19/2013
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Provider Practice Location Address
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Address Line | 6206 PETERS CREEK RD
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City | ROANOKE
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State | VA
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Zip | 24019-4026
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Country | US
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Telephone | 540-563-0334
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Fax | 540-563-0122
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Provider Business Mailing Address
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Address Line | 6206 PETERS CREEK RD
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City | ROANOKE
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State | VA
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Zip | 24019-4026
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Country | US
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Telephone | 540-563-0334
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Fax | 540-563-0122
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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 | 0104556699
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 011636
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 3917
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License Number State | NC
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