=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770583692
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LUCINDA SEAVER
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/22/2005
-----------------------------------------------------
Last Update Date | 02/12/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 97 RAILROAD RD
-----------------------------------------------------
City | WESTPOINT
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 38486-5310
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 866-724-0465
-----------------------------------------------------
Fax | 931-853-4243
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 177
-----------------------------------------------------
City | WESTPOINT
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 38486-0177
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 866-724-0465
-----------------------------------------------------
Fax | 931-853-4243
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/ULTRASONOGRAPHER
-----------------------------------------------------
Name | LUCINDA SEAVER
-----------------------------------------------------
Credential | RT(R),RDCS,RDMS,RVT
-----------------------------------------------------
Telephone | 866-724-0465
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2471S1302X
-----------------------------------------------------
Taxonomy Name | Sonography Radiologic Technologist
-----------------------------------------------------
License Number | MDX0000003533
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------