Healthcare Provider Details

I. General information

NPI: 1487754529
Provider Name (Legal Business Name): JAMES PETER SEIM DC, DACBN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20010 75TH AVE N
CORCORAN MN
55340-9459
US

IV. Provider business mailing address

20010 75TH AVE N
CORCORAN MN
55340-9459
US

V. Phone/Fax

Practice location:
  • Phone: 763-416-4878
  • Fax:
Mailing address:
  • Phone: 763-416-4878
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number1424
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: