Provider Demographics
NPI:1407960644
Name:LEVINE, SETH L (DC)
Entity Type:Individual
Prefix:
First Name:SETH
Middle Name:L
Last Name:LEVINE
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 1:209 HARVARD ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-5071
Mailing Address - Country:US
Mailing Address - Phone:617-232-7744
Mailing Address - Fax:617-232-4040
Practice Address - Street 1:209 HARVARD ST
Practice Address - Street 2:SUITE 204
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-5071
Practice Address - Country:US
Practice Address - Phone:617-232-7744
Practice Address - Fax:617-232-4040
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA578111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor