Healthcare Provider Details

I. General information

NPI: 1225523178
Provider Name (Legal Business Name): KYLE SEYMOUR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2018
Last Update Date: 02/09/2025
Certification Date: 02/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

818 CONNECTICUT AVE NW STE 500
WASHINGTON DC
20006-2713
US

IV. Provider business mailing address

522 E HANNA DR
NEWARK DE
19702-2702
US

V. Phone/Fax

Practice location:
  • Phone: 202-455-8710
  • Fax:
Mailing address:
  • Phone: 302-562-9609
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: