Healthcare Provider Details

I. General information

NPI: 1073312849
Provider Name (Legal Business Name): BRITTANY NICOLE SEALS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

1500 MOUNT VERNON AVE
COLUMBUS OH
43203-1616
US

IV. Provider business mailing address

153 N CHAMPION AVE
COLUMBUS OH
43203-1559
US

V. Phone/Fax

Practice location:
  • Phone: 614-917-7274
  • Fax:
Mailing address:
  • Phone: 614-917-7274
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code405300000X
TaxonomyPrevention Professional
License NumberTG234681
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: