Provider Demographics
NPI:1922281799
Name:OQUIST, SEAN ROBERT (DC)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:ROBERT
Last Name:OQUIST
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 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LAMAR
Mailing Address - State:CO
Mailing Address - Zip Code:81052-3222
Mailing Address - Country:US
Mailing Address - Phone:719-336-6800
Mailing Address - Fax:
Practice Address - Street 1:109 W. LEE AVE.
Practice Address - Street 2:SUITE 10-2
Practice Address - City:LAMAR
Practice Address - State:CO
Practice Address - Zip Code:81052
Practice Address - Country:US
Practice Address - Phone:719-336-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-14
Last Update Date:2018-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6160111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor