Provider Demographics
NPI:1851438345
Name:SEYMORE, BRIAN L (DC, PT, DIBE, DABCE)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:L
Last Name:SEYMORE
Suffix:
Gender:M
Credentials:DC, PT, DIBE, DABCE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10845 PHILADELPHIA RD
Mailing Address - Street 2:
Mailing Address - City:WHITE MARSH
Mailing Address - State:MD
Mailing Address - Zip Code:21162-1717
Mailing Address - Country:US
Mailing Address - Phone:410-335-0008
Mailing Address - Fax:
Practice Address - Street 1:602 S ATWOOD RD STE 206
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-4329
Practice Address - Country:US
Practice Address - Phone:866-526-8088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03390111NR0400X
MD20804204R00000X
MD20804- PT174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialist
No111NR0400XChiropractic ProvidersChiropractorRehabilitation
No204R00000XAllopathic & Osteopathic PhysiciansElectrodiagnostic MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD113NM774Medicare ID - Type UnspecifiedPHYSICAL THERAPIST
MD113N017GMedicare ID - Type UnspecifiedCHIROPRACTOR
MDV03999Medicare UPIN