MEDICARE: MRS. TIFFANY MARIE SEICK CPHT

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	247200000X	Other Technician	0230027765	VA

General Provider Information

NPI Number	:	1780045054
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TIFFANY MARIE SEICK CPHT

Provider Business Mailing Address
First Line	:	4901 FALCON CREEK WAY
Second Line	:	APT 302
City	:	HAMPTON
State	:	VA
Zip	:	23666-0608
Country	:	US
Telephone Number	:	513-849-0655
Fax Number	:

Provider Business Practice Location Address
First Line	:	4901 FALCON CREEK WAY
Second Line	:	APT 302
City	:	HAMPTON
State	:	VA
Zip	:	23666-0608
Country	:	US
Telephone Number	:	513-849-0655
Fax Number	:

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

Provider Enumeration Date	:	03/15/2016
Last Update Date	:	03/15/2016

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