MEDICARE: SETH ENTERPRISES I

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

General Provider Information

NPI Number	:	1205946910
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SETH ENTERPRISES I

Provider Business Mailing Address
First Line	:	3010 WEST LAKE RD
Second Line	:
City	:	ERIE
State	:	PA
Zip	:	16505-3849
Country	:	US
Telephone Number	:	814-833-2022
Fax Number	:	814-838-1223

Provider Business Practice Location Address
First Line	:	3010 WEST LAKE RD
Second Line	:
City	:	ERIE
State	:	PA
Zip	:	16505-3849
Country	:	US
Telephone Number	:	814-833-2022
Fax Number	:	814-838-1223

Authorized Official
Title or Position	:	OWNER PHYSICAL THERAPIST
Name	:	SEAN PAUL SETH
Credential	:	PT
Telephone Number	:	814-833-2022

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	07/23/2010

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1750491460 — SEAN PAUL SETH PT
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Directions to “SETH ENTERPRISES I ” Practice Location

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