Provider Demographics
NPI:1205946910
Name:SETH ENTERPRISES I
Entity type:Organization
Organization Name:SETH ENTERPRISES I
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:SETH
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:814-833-2022
Mailing Address - Street 1:3010 WEST LAKE RD
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16505-3849
Mailing Address - Country:US
Mailing Address - Phone:814-833-2022
Mailing Address - Fax:814-838-1223
Practice Address - Street 1:3010 WEST LAKE RD
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16505-3849
Practice Address - Country:US
Practice Address - Phone:814-833-2022
Practice Address - Fax:814-838-1223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2010-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA071941Medicare ID - Type Unspecified