Provider Demographics
NPI:1831313741
Name:DEBRA L SEYMOUR
Entity Type:Organization
Organization Name:DEBRA L SEYMOUR
Other - Org Name:ARTISTIC DESIGNS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COSMETOLOGIST/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:SEYMOUR
Authorized Official - Suffix:
Authorized Official - Credentials:CMF
Authorized Official - Phone:406-782-5775
Mailing Address - Street 1:305 E FRONT ST
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-5205
Mailing Address - Country:US
Mailing Address - Phone:406-782-5775
Mailing Address - Fax:
Practice Address - Street 1:305 E FRONT ST
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-5205
Practice Address - Country:US
Practice Address - Phone:406-782-5775
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2013-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT3043332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT311290OtherBLUE CROSS BLUE SHIELD
MT5606692Medicaid
MT4586440001Medicare ID - Type Unspecified