Provider Demographics
NPI:1932516150
Name:WALKER, SEAN (DC)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:WALKER
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 1:11420 BLONDO ST
Mailing Address - Street 2:STE 102
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68164-3858
Mailing Address - Country:US
Mailing Address - Phone:402-496-8972
Mailing Address - Fax:402-496-8972
Practice Address - Street 1:2085 N 120TH ST
Practice Address - Street 2:SUITE D-6
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68164-3479
Practice Address - Country:US
Practice Address - Phone:402-496-8972
Practice Address - Fax:402-496-8972
Is Sole Proprietor?:No
Enumeration Date:2014-07-21
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1808111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor