Provider Demographics
NPI:1366491458
Name:SEEDS, ROBERT HENRY (PT PHD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:HENRY
Last Name:SEEDS
Suffix:
Gender:M
Credentials:PT PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3699 JEFFERS PARKWAY NORTHWEST
Mailing Address - Street 2:
Mailing Address - City:PRIOR LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55372-4476
Mailing Address - Country:US
Mailing Address - Phone:414-731-0295
Mailing Address - Fax:
Practice Address - Street 1:2520 PILOT KNOB RD
Practice Address - Street 2:SUITE 250
Practice Address - City:MENDOTA HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55120-1137
Practice Address - Country:US
Practice Address - Phone:651-224-8264
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7661225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN7661OtherSTATE LICENSE NUMBER