Provider Demographics
NPI:1003308891
Name:SEEVERS, BRENNAN R (DPT)
Entity Type:Individual
Prefix:
First Name:BRENNAN
Middle Name:R
Last Name:SEEVERS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:586 S STATE ROAD 135 STE E
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46142-1444
Mailing Address - Country:US
Mailing Address - Phone:317-881-0101
Mailing Address - Fax:317-881-6261
Practice Address - Street 1:586 S STATE ROAD 135 STE E
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46142-1444
Practice Address - Country:US
Practice Address - Phone:317-881-0101
Practice Address - Fax:317-881-6261
Is Sole Proprietor?:No
Enumeration Date:2018-06-06
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05012925A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist