Provider Demographics
NPI:1356950463
Name:SEYMOUR, DARREN LOGAN (PT, DPT)
Entity type:Individual
Prefix:
First Name:DARREN
Middle Name:LOGAN
Last Name:SEYMOUR
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5906
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31758-5906
Mailing Address - Country:US
Mailing Address - Phone:229-236-8989
Mailing Address - Fax:
Practice Address - Street 1:223 S CRAWFORD ST
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:GA
Practice Address - Zip Code:31792-5504
Practice Address - Country:US
Practice Address - Phone:229-236-8989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-24
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist