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General NPI Number Information
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NPI Number | 1588557193
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Entity Type | Individual
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Provider Name | JACOB SEELY PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 06/02/2025
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Last Update Date | 01/12/2026
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Provider Practice Location Address
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Address Line | 1601 NW 114TH ST STE 155
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City | CLIVE
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State | IA
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Zip | 50325-7046
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Country | US
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Telephone | 515-222-7350
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Fax | 515-222-7355
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Provider Business Mailing Address
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Address Line | PO BOX 674721
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City | DALLAS
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State | TX
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Zip | 75267-4721
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Country | US
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Telephone | 515-643-2519
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Fax | 515-222-7355
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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 | 133035
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License Number State | IA
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