Provider Demographics
NPI:1174975700
Name:SELLERS, CLINTON (DC, MS, CCSP)
Entity type:Individual
Prefix:DR
First Name:CLINTON
Middle Name:
Last Name:SELLERS
Suffix:
Gender:M
Credentials:DC, MS, CCSP
Other - Prefix:DR
Other - First Name:CLINT
Other - Middle Name:
Other - Last Name:SELLERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC, MS, CCSP
Mailing Address - Street 1:3948 BROWNING PL STE 110
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-6512
Mailing Address - Country:US
Mailing Address - Phone:919-699-8184
Mailing Address - Fax:919-480-2757
Practice Address - Street 1:3948 BROWNING PL STE 110
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-6512
Practice Address - Country:US
Practice Address - Phone:919-699-8184
Practice Address - Fax:919-480-2757
Is Sole Proprietor?:No
Enumeration Date:2016-07-07
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4646111NS0005X, 111NR0400X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NS0005XChiropractic ProvidersChiropractorSports Physician
No111NR0400XChiropractic ProvidersChiropractorRehabilitation