Provider Demographics
NPI:1821048208
Name:SMITH, SEAN THOMAS (DC)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:THOMAS
Last Name:SMITH
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 1:291 W 1000 N
Mailing Address - Street 2:
Mailing Address - City:SPRINGVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84663-4207
Mailing Address - Country:US
Mailing Address - Phone:563-340-8140
Mailing Address - Fax:
Practice Address - Street 1:1220 N MAIN ST
Practice Address - Street 2:SUITE 12
Practice Address - City:SPRINGVILLE
Practice Address - State:UT
Practice Address - Zip Code:84663-4013
Practice Address - Country:US
Practice Address - Phone:801-489-9230
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6142883-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor