Provider Demographics
NPI:1447581509
Name:SEASTEDT, DAVID LUCAS (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:LUCAS
Last Name:SEASTEDT
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 1:2166 SHERWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40205-1114
Mailing Address - Country:US
Mailing Address - Phone:859-338-3898
Mailing Address - Fax:
Practice Address - Street 1:1512 CRUMS LN
Practice Address - Street 2:SUITE 100
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40216-3861
Practice Address - Country:US
Practice Address - Phone:859-338-3898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-28
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5197111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor