Provider Demographics
NPI:1316955594
Name:CHARTIER, SEAN EVERETTE (DC)
Entity type:Individual
Prefix:DR
First Name:SEAN
Middle Name:EVERETTE
Last Name:CHARTIER
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 1:2601 APACHE CT
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51104-1504
Mailing Address - Country:US
Mailing Address - Phone:712-277-9355
Mailing Address - Fax:712-277-9366
Practice Address - Street 1:2601 APACHE CT
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51104-1504
Practice Address - Country:US
Practice Address - Phone:712-277-9355
Practice Address - Fax:712-277-9366
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06891111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0497446Medicaid
IAI21041OtherGROUP MEDICARE PIN
IA1316955594OtherPROVIDER NPI
IA1982896353OtherGROUP NPI
IA0497446Medicaid
IA1982896353OtherGROUP NPI