Provider Demographics
NPI:1285718627
Name:JENKINS, SEAN PAUL (DC)
Entity type:Individual
Prefix:DR
First Name:SEAN
Middle Name:PAUL
Last Name:JENKINS
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 1:2820 S ALMA SCHOOL RD
Mailing Address - Street 2:2A6
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85248-3192
Mailing Address - Country:US
Mailing Address - Phone:520-836-2969
Mailing Address - Fax:
Practice Address - Street 1:1891 N TREKELL RD
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85222-1704
Practice Address - Country:US
Practice Address - Phone:520-836-2969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7486111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0941841OtherBLUE CROSS BLUE SHIELD