Provider Demographics
NPI:1891189247
Name:SEYMOUR, CHANLAR (OTR)
Entity Type:Individual
Prefix:
First Name:CHANLAR
Middle Name:
Last Name:SEYMOUR
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:CHANLAR
Other - Middle Name:
Other - Last Name:PIERCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3500 WYNFIELD DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:IN
Mailing Address - Zip Code:47374-8307
Mailing Address - Country:US
Mailing Address - Phone:765-524-8723
Mailing Address - Fax:
Practice Address - Street 1:3500 WYNFIELD DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:IN
Practice Address - Zip Code:47374-8307
Practice Address - Country:US
Practice Address - Phone:765-524-8723
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-24
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31005819A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist