Provider Demographics
NPI:1437487329
Name:COFFRON, SEAN ROBERT (PHD)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:ROBERT
Last Name:COFFRON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 61
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:VA
Mailing Address - Zip Code:22642-0061
Mailing Address - Country:US
Mailing Address - Phone:540-622-7131
Mailing Address - Fax:
Practice Address - Street 1:80 OREGON HOLLOW RD
Practice Address - Street 2:
Practice Address - City:FRONT ROYAL
Practice Address - State:VA
Practice Address - Zip Code:22630-6160
Practice Address - Country:US
Practice Address - Phone:540-622-7131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-03
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator