Provider Demographics
NPI:1528619186
Name:ZIEMBA, SEAN MITCHELL
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:MITCHELL
Last Name:ZIEMBA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 OSAGE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-2656
Mailing Address - Country:US
Mailing Address - Phone:219-730-4772
Mailing Address - Fax:
Practice Address - Street 1:3801 OSAGE ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-2656
Practice Address - Country:US
Practice Address - Phone:303-955-5994
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-25
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR.0008080111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician