Provider Demographics
NPI:1558975938
Name:SEGUIN, STEVEN (PT)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:SEGUIN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:567 S GRAPE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246-1416
Mailing Address - Country:US
Mailing Address - Phone:303-475-5102
Mailing Address - Fax:844-689-1158
Practice Address - Street 1:600 S CHERRY ST STE 145
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80246-1703
Practice Address - Country:US
Practice Address - Phone:303-475-5102
Practice Address - Fax:844-689-1158
Is Sole Proprietor?:No
Enumeration Date:2020-09-03
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR63861225100000X
CO0017706225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist