Provider Demographics
NPI:1740309210
Name:SEANEY, SHAWN ERIC (DC)
Entity type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:ERIC
Last Name:SEANEY
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 1:3320 DAHLONEGA HWY
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30028-3915
Mailing Address - Country:US
Mailing Address - Phone:770-888-9265
Mailing Address - Fax:770-888-9266
Practice Address - Street 1:3320 DAHLONEGA HWY
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30028-3915
Practice Address - Country:US
Practice Address - Phone:770-888-9265
Practice Address - Fax:770-888-9266
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR007623111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAP00335595OtherPALMETTO GBA MEDICARE RR#
GAP00335595OtherPALMETTO GBA MEDICARE RR#
GA35ZCHTNMedicare PIN