Provider Demographics
NPI:1558503821
Name:SEED, BENJAMIN SCOTT (DC)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:SCOTT
Last Name:SEED
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 1:1827 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CARBONDALE
Mailing Address - State:IL
Mailing Address - Zip Code:62901-2123
Mailing Address - Country:US
Mailing Address - Phone:618-694-2201
Mailing Address - Fax:
Practice Address - Street 1:1827 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CARBONDALE
Practice Address - State:IL
Practice Address - Zip Code:62901-2123
Practice Address - Country:US
Practice Address - Phone:618-694-2201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-01
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.011375111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor