Provider Demographics
NPI:1215232699
Name:CONNOR, SEAN MICHAEL (DC, BA, BS)
Entity type:Individual
Prefix:DR
First Name:SEAN
Middle Name:MICHAEL
Last Name:CONNOR
Suffix:
Gender:M
Credentials:DC, BA, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 605
Mailing Address - Street 2:
Mailing Address - City:BLAIR
Mailing Address - State:NE
Mailing Address - Zip Code:68008-0605
Mailing Address - Country:US
Mailing Address - Phone:531-625-9185
Mailing Address - Fax:402-939-0773
Practice Address - Street 1:924 GRANT ST
Practice Address - Street 2:
Practice Address - City:BLAIR
Practice Address - State:NE
Practice Address - Zip Code:68008-2153
Practice Address - Country:US
Practice Address - Phone:402-426-0404
Practice Address - Fax:402-939-0773
Is Sole Proprietor?:No
Enumeration Date:2011-01-17
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1684111N00000X
IA007373111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE1684OtherSTATE LICENSE