MEDICARE: MR. EDWARD B SEITZ PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	05006288A	IN

General Provider Information

NPI Number	:	1073250353
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. EDWARD B SEITZ PT

Provider Business Mailing Address
First Line	:	310 W TANSEY XING
Second Line	:
City	:	WESTFIELD
State	:	IN
Zip	:	46074-9743
Country	:	US
Telephone Number	:	317-514-3950
Fax Number	:

Provider Business Practice Location Address
First Line	:	10480 GLASSWATER LN
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46231-0009
Country	:	US
Telephone Number	:	317-514-3950
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2022
Last Update Date	:	05/17/2022

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Directions to “ MR. EDWARD B SEITZ PT” Practice Location

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