Provider Demographics
NPI:1629217468
Name:SEYMOUR, JULIE LYNN (PT)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:LYNN
Last Name:SEYMOUR
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4030 CREEKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:SWANTON
Mailing Address - State:OH
Mailing Address - Zip Code:43558-8640
Mailing Address - Country:US
Mailing Address - Phone:419-356-6812
Mailing Address - Fax:
Practice Address - Street 1:4030 CREEKSIDE DR
Practice Address - Street 2:
Practice Address - City:SWANTON
Practice Address - State:OH
Practice Address - Zip Code:43558-8640
Practice Address - Country:US
Practice Address - Phone:419-356-6812
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-18
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH011596225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist