Healthcare Provider Details

I. General information

NPI: 1851351506
Provider Name (Legal Business Name): WILLIAM A SEEGLITZ JR. D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2006
Last Update Date: 07/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

437 NEWTONVILLE AVE SUITE 3
NEWTONVILLE MA
02460-1934
US

IV. Provider business mailing address

437 NEWTONVILLE AVE SUITE 3
NEWTONVILLE MA
02460-1934
US

V. Phone/Fax

Practice location:
  • Phone: 617-964-5959
  • Fax: 617-964-2452
Mailing address:
  • Phone: 617-964-5959
  • Fax: 617-964-2452

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number73155
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: