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General NPI Number Information
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NPI Number | 1255665550
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Entity Type | Individual
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Provider Name | SETH LYNN STALEY P.T.
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Gender | Male
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Dates
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Enumeration Date | 09/21/2009
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 9885 GREENBELT RD
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City | LANHAM
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State | MD
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Zip | 20706-2302
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Country | US
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Telephone | 877-407-3422
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Fax | 877-407-4329
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Provider Business Mailing Address
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Address Line | 840 DEWEY AVE
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City | HAGERSTOWN
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State | MD
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Zip | 21742-3939
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Country | US
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Telephone | 301-991-5188
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 23070
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License Number State | MD
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