Provider Demographics
NPI:1225432206
Name:UNDERWOOD, SETH M (DC)
Entity Type:Individual
Prefix:
First Name:SETH
Middle Name:M
Last Name:UNDERWOOD
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 1:109 MINUS AVE
Mailing Address - Street 2:SUITE C-2
Mailing Address - City:GARDEN CITY
Mailing Address - State:GA
Mailing Address - Zip Code:31408
Mailing Address - Country:US
Mailing Address - Phone:912-966-2632
Mailing Address - Fax:912-355-1848
Practice Address - Street 1:109 MINUS AVE
Practice Address - Street 2:SUITE C-2
Practice Address - City:GARDEN CITY
Practice Address - State:GA
Practice Address - Zip Code:31408
Practice Address - Country:US
Practice Address - Phone:912-966-2632
Practice Address - Fax:912-355-1848
Is Sole Proprietor?:No
Enumeration Date:2014-10-20
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR009390111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor