MEDICARE: SETH WEBER P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	5311	SC

General Provider Information

NPI Number	:	1184739427
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SETH WEBER P.T.

Provider Business Mailing Address
First Line	:	3930 RIDGEWOOD DR
Second Line	:
City	:	ROCK HILL
State	:	SC
Zip	:	29732-8657
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	231 S HERLONG AVE
Second Line	:
City	:	ROCK HILL
State	:	SC
Zip	:	29732-1159
Country	:	US
Telephone Number	:	803-366-4415
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2006
Last Update Date	:	07/08/2007

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Directions to “ SETH WEBER P.T.” Practice Location

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