Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | DC-006988-L | PA |
NPI | 1003959107 |
---|---|
Provider Name | Dr. Sean Hopkins |
First Address | Bridgeville, PA 15017-2033 |
Second Address | Bridgeville, PA 15017-2033 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2007 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
065050 | BLUE CROSS BLUE SHIELD (01) | PA |
304691 | UPMC (01) | PA |
U74912 | (02) | PA |