Provider Demographics
NPI:1811307911
Name:SEXTON, DORRANCE
Entity type:Individual
Prefix:
First Name:DORRANCE
Middle Name:
Last Name:SEXTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:CHIP
Other - Middle Name:
Other - Last Name:SEXTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DOM, LAC
Mailing Address - Street 1:455 NE 5TH AVE
Mailing Address - Street 2:SUITE D-175
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-5658
Mailing Address - Country:US
Mailing Address - Phone:561-891-9159
Mailing Address - Fax:
Practice Address - Street 1:160 SE 6TH AVE
Practice Address - Street 2:SUITE B-2
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-5264
Practice Address - Country:US
Practice Address - Phone:561-325-8612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-29
Last Update Date:2014-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP 3413171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist