Healthcare Provider Details

I. General information

NPI: 1851438345
Provider Name (Legal Business Name): BRIAN L SEYMORE DC, PT, DIBE, DABCE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7600 OSLER DR STE 105
TOWSON MD
21204-7705
US

IV. Provider business mailing address

7180 KODIAK RD NE
RIO RANCHO NM
87144-8200
US

V. Phone/Fax

Practice location:
  • Phone: 866-526-8088
  • Fax:
Mailing address:
  • Phone: 866-526-8088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number03390
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code204R00000X
TaxonomyElectrodiagnostic Medicine Physician
License Number20804
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number20804- PT
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: