Provider Demographics
NPI:1417718586
Name:JEWELL-SEAGER, TAYLOR LYNN (DC)
Entity Type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:LYNN
Last Name:JEWELL-SEAGER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8866 STATE ROUTE 415
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:NY
Mailing Address - Zip Code:14821-9721
Mailing Address - Country:US
Mailing Address - Phone:607-368-9690
Mailing Address - Fax:
Practice Address - Street 1:56 MAIN STREET
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:PA
Practice Address - Zip Code:16929
Practice Address - Country:US
Practice Address - Phone:570-827-2700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC011865111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor