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NPI Code Detail

MEDICARE: ROBERT HENRY SEEDS P.T. PHD

MEDICARE: ROBERT HENRY SEEDS P.T. PHD
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
1225100000XPhysical Therapist7661MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
17661OTHERMNSTATE LICENSE NUMBER

General Provider Information

NPI Number : 1366491458
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT HENRY SEEDS P.T. PHD
Provider Business Mailing Address
First Line : 3699 JEFFERS PARKWAY NORTHWEST
Second Line :
City : PRIOR LAKE
State : MN
Zip : 55372-4476
Country : US
Telephone Number : 414-731-0295
Fax Number :
Provider Business Practice Location Address
First Line : 2520 PILOT KNOB RD
Second Line : SUITE 250
City : MENDOTA HEIGHTS
State : MN
Zip : 55120-1137
Country : US
Telephone Number : 651-224-8264
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2006
Last Update Date : 07/08/2007

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