Provider Demographics
NPI:1063554723
Name:HALPIN, SEAN CEDRIC (DC)
Entity type:Individual
Prefix:DR
First Name:SEAN
Middle Name:CEDRIC
Last Name:HALPIN
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:W236 S7050 HWY164
Mailing Address - Street 2:STE. 4
Mailing Address - City:BIG BEND
Mailing Address - State:WI
Mailing Address - Zip Code:53103
Mailing Address - Country:US
Mailing Address - Phone:262-662-9820
Mailing Address - Fax:262-662-9821
Practice Address - Street 1:W236 S7050 HWY164
Practice Address - Street 2:STE. 4
Practice Address - City:BIG BEND
Practice Address - State:WI
Practice Address - Zip Code:53103
Practice Address - Country:US
Practice Address - Phone:262-662-9820
Practice Address - Fax:262-662-9821
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3674-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38928600Medicaid
WI38928600Medicaid
WI0001Medicare UPIN