Provider Demographics
NPI:1619202363
Name:SEAGER, MARK (RT)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:
Last Name:SEAGER
Suffix:
Gender:M
Credentials:RT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:163 3RD ST
Mailing Address - Street 2:
Mailing Address - City:TRACY
Mailing Address - State:MN
Mailing Address - Zip Code:56175-1211
Mailing Address - Country:US
Mailing Address - Phone:507-629-8232
Mailing Address - Fax:
Practice Address - Street 1:163 3RD ST
Practice Address - Street 2:
Practice Address - City:TRACY
Practice Address - State:MN
Practice Address - Zip Code:56175-1211
Practice Address - Country:US
Practice Address - Phone:507-629-8232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-14
Last Update Date:2009-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies