Provider Demographics
NPI:1114246527
Name:DELETETSKY, SETH M (DC)
Entity Type:Individual
Prefix:
First Name:SETH
Middle Name:M
Last Name:DELETETSKY
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 1:4022 OLD BRIDGE RD SE STE D
Mailing Address - Street 2:
Mailing Address - City:SOUTHPORT
Mailing Address - State:NC
Mailing Address - Zip Code:28461-9286
Mailing Address - Country:US
Mailing Address - Phone:910-363-4139
Mailing Address - Fax:910-363-4258
Practice Address - Street 1:4022 OLD BRIDGE RD SE STE D
Practice Address - Street 2:
Practice Address - City:SOUTHPORT
Practice Address - State:NC
Practice Address - Zip Code:28461-9286
Practice Address - Country:US
Practice Address - Phone:910-363-4139
Practice Address - Fax:910-363-4258
Is Sole Proprietor?:No
Enumeration Date:2010-05-25
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4572111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor