Provider Demographics
NPI:1043427651
Name:SEWARD, JOHN JENNINGS (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:JENNINGS
Last Name:SEWARD
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 1:1 BELMONT AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-1617
Mailing Address - Country:US
Mailing Address - Phone:610-617-7300
Mailing Address - Fax:610-617-3325
Practice Address - Street 1:1 BELMONT AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-1617
Practice Address - Country:US
Practice Address - Phone:610-617-7300
Practice Address - Fax:610-617-3325
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007482L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1604960OtherBLUE SHIELD
PA0000034913Medicare ID - Type UnspecifiedMEDICARE