Provider Demographics
NPI:1629287370
Name:REIF, SEAN M (DC)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:M
Last Name:REIF
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 1:10374 COLORADO BLVD
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80229-2703
Mailing Address - Country:US
Mailing Address - Phone:303-452-2678
Mailing Address - Fax:303-452-4470
Practice Address - Street 1:10374 COLORADO BLVD
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80229-2703
Practice Address - Country:US
Practice Address - Phone:303-452-2678
Practice Address - Fax:303-452-4470
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3986111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO841289167OtherTAX ID
CO841289167OtherTAX ID