Provider Demographics
NPI:1871769927
Name:DUNLEAVY, SEAN MEYER (DC)
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:MEYER
Last Name:DUNLEAVY
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 1:2851 N TENAYA WAY
Mailing Address - Street 2:#103
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-0435
Mailing Address - Country:US
Mailing Address - Phone:702-309-4878
Mailing Address - Fax:702-309-4879
Practice Address - Street 1:2851 N TENAYA WAY
Practice Address - Street 2:#103
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0435
Practice Address - Country:US
Practice Address - Phone:702-309-4878
Practice Address - Fax:702-309-4879
Is Sole Proprietor?:No
Enumeration Date:2008-05-07
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB-785111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV38409Medicare PIN