Provider Demographics
NPI:1760555080
Name:LAURAITIS, SEAN (DC)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:
Last Name:LAURAITIS
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 1:3700 S RAILROAD ST
Mailing Address - Street 2:STE B
Mailing Address - City:PHENIX CITY
Mailing Address - State:AL
Mailing Address - Zip Code:36867-2994
Mailing Address - Country:US
Mailing Address - Phone:334-298-7700
Mailing Address - Fax:866-537-1711
Practice Address - Street 1:1935 S COLLEGE ST
Practice Address - Street 2:STE. C
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36832-5874
Practice Address - Country:US
Practice Address - Phone:334-887-8383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2033111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor