Provider Demographics
NPI:1033121199
Name:HAMPTON, SEAN D (DC)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:D
Last Name:HAMPTON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2625 S RAINBOW BLVD STE C102
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-5181
Mailing Address - Country:US
Mailing Address - Phone:702-387-4577
Mailing Address - Fax:702-873-2480
Practice Address - Street 1:2625 S RAINBOW BLVD STE C102
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-5181
Practice Address - Country:US
Practice Address - Phone:702-387-4577
Practice Address - Fax:702-873-2480
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB01003111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV38741Medicare ID - Type Unspecified
NVU97346Medicare UPIN