Provider Demographics
NPI:1780894238
Name:HOLDER, SEAN E (DC)
Entity type:Individual
Prefix:DR
First Name:SEAN
Middle Name:E
Last Name:HOLDER
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 1:317 CARLISLE AVE
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17404-3203
Mailing Address - Country:US
Mailing Address - Phone:717-848-2236
Mailing Address - Fax:717-848-2236
Practice Address - Street 1:317 CARLISLE AVE
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17404-3203
Practice Address - Country:US
Practice Address - Phone:717-848-2236
Practice Address - Fax:717-848-2236
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007064-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA036380OtherHIGHMARK BLUE SHIELD
PA036380OtherHIGHMARK BLUE SHIELD