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General NPI Number Information
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NPI Number | 1306290119
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Entity Type | Individual
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Provider Name | JOSEPH SEYFORTH
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Gender | Male
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Dates
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Enumeration Date | 04/18/2016
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Last Update Date | 09/16/2020
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Provider Practice Location Address
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Address Line | 22120 MIDLAND DR # 1
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City | SHAWNEE
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State | KS
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Zip | 66226-3554
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Country | US
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Telephone | 815-277-7069
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Fax |
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Provider Business Mailing Address
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Address Line | 8422 LOCUST ST
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City | KANSAS CITY
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State | MO
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Zip | 64131-2222
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Country | US
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Telephone | 815-277-7069
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 11-06605
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License Number State | KS
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Taxonomy #3
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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