Provider Demographics
NPI:1124401880
Name:SEIDER, ABBY (DPT)
Entity Type:Individual
Prefix:DR
First Name:ABBY
Middle Name:
Last Name:SEIDER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 NW MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64086-9311
Mailing Address - Country:US
Mailing Address - Phone:816-524-7040
Mailing Address - Fax:816-524-7057
Practice Address - Street 1:800 NW MAIN ST
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64086-9311
Practice Address - Country:US
Practice Address - Phone:816-524-7040
Practice Address - Fax:816-524-7057
Is Sole Proprietor?:No
Enumeration Date:2015-06-30
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015021392225100000X
KS11-05054225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist