MEDICARE: DR. THOMAS PEYTON SEABOLT PT, DPT, EP-C

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	PT014615	GA

General Provider Information

NPI Number	:	1386252898
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS PEYTON SEABOLT PT, DPT, EP-C

Provider Business Mailing Address
First Line	:	33900 HARPER AVE STE 104
Second Line	:
City	:	CLINTON TWP
State	:	MI
Zip	:	48035-4258
Country	:	US
Telephone Number	:	586-350-2644
Fax Number	:

Provider Business Practice Location Address
First Line	:	6236 HOLLY SPRINGS PKWY
Second Line	:	STE D8
City	:	WOODSTOCK
State	:	GA
Zip	:	30188
Country	:	US
Telephone Number	:	770-926-9112
Fax Number	:

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

Provider Enumeration Date	:	07/21/2020
Last Update Date	:	02/07/2025

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