Provider Demographics
NPI:1528463122
Name:AGGER, SEAN (PHD, DBACC)
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:AGGER
Suffix:
Gender:M
Credentials:PHD, DBACC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7516 80TH ST S
Mailing Address - Street 2:
Mailing Address - City:COTTAGE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55016-3177
Mailing Address - Country:US
Mailing Address - Phone:612-200-3445
Mailing Address - Fax:
Practice Address - Street 1:7516 80TH ST S
Practice Address - Street 2:
Practice Address - City:COTTAGE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55016-3177
Practice Address - Country:US
Practice Address - Phone:612-200-3445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-27
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor