Provider Demographics
NPI:1407951031
Name:LABUDA, SEAN BERNARD (DC)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:BERNARD
Last Name:LABUDA
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 1:401 CEDAR HILL DR
Mailing Address - Street 2:
Mailing Address - City:MCMURRAY
Mailing Address - State:PA
Mailing Address - Zip Code:15317-2530
Mailing Address - Country:US
Mailing Address - Phone:724-984-2209
Mailing Address - Fax:
Practice Address - Street 1:357 E MAIDEN ST
Practice Address - Street 2:SUITE 204
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-5106
Practice Address - Country:US
Practice Address - Phone:724-222-2660
Practice Address - Fax:724-223-0933
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-007831-L111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA46028OtherHIGHMARK
PA001961028Medicaid
PA46028OtherHIGHMARK
PAU82195Medicare UPIN