Provider Demographics
NPI:1407017221
Name:SEAN B. MANDEL, DC, PC
Entity Type:Organization
Organization Name:SEAN B. MANDEL, DC, PC
Other - Org Name:SHARP CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AO / PROVIDER/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:BENJAMIN
Authorized Official - Last Name:MANDEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:267-258-6246
Mailing Address - Street 1:6 MYSTIC LN
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-1942
Mailing Address - Country:US
Mailing Address - Phone:610-889-9242
Mailing Address - Fax:610-889-1316
Practice Address - Street 1:6 MYSTIC LN
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:PA
Practice Address - Zip Code:19355
Practice Address - Country:US
Practice Address - Phone:610-889-9244
Practice Address - Fax:610-889-1316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-24
Last Update Date:2018-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC008976111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty