Provider Demographics
NPI:1669594768
Name:LABOTT, SETH EVAN (DC)
Entity type:Individual
Prefix:DR
First Name:SETH
Middle Name:EVAN
Last Name:LABOTT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941-1539
Mailing Address - Country:US
Mailing Address - Phone:415-888-3629
Mailing Address - Fax:415-389-1097
Practice Address - Street 1:465 MILLER AVE
Practice Address - Street 2:
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941-2941
Practice Address - Country:US
Practice Address - Phone:415-389-1098
Practice Address - Fax:415-389-1097
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 27249111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor