Provider Demographics
NPI:1245221431
Name:THOMPSON, SEAN HUGH (DC CCAP)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:HUGH
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:DC CCAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12539 NORTH HWY 83
Mailing Address - Street 2:UNIT B
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-8820
Mailing Address - Country:US
Mailing Address - Phone:720-325-9886
Mailing Address - Fax:720-278-7861
Practice Address - Street 1:12539 NORTH HWY 83
Practice Address - Street 2:UNIT B
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-8820
Practice Address - Country:US
Practice Address - Phone:720-325-9886
Practice Address - Fax:720-278-7861
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-04
Last Update Date:2014-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC25280111N00000X
CO6601111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU70480Medicare UPIN