Provider Demographics
NPI:1780224048
Name:SEWARD, MICHELLE (DC)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:SEWARD
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12479 S ACCESS RD
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33981-6206
Mailing Address - Country:US
Mailing Address - Phone:941-229-1887
Mailing Address - Fax:
Practice Address - Street 1:12479 S ACCESS RD
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33981-6206
Practice Address - Country:US
Practice Address - Phone:941-229-1887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-14
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL13030111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty