MEDICARE: ERIN KATHLEEN SEABOLT D.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	111N00000X	Chiropractor	6114	TX

General Provider Information

NPI Number	:	1588696272
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN KATHLEEN SEABOLT D.C.

Provider Business Mailing Address
First Line	:	3232 13TH AVE N
Second Line	:
City	:	TEXAS CITY
State	:	TX
Zip	:	77590-4514
Country	:	US
Telephone Number	:	409-948-8577
Fax Number	:	409-948-8578

Provider Business Practice Location Address
First Line	:	3232 13TH AVE N
Second Line	:
City	:	TEXAS CITY
State	:	TX
Zip	:	77590-4514
Country	:	US
Telephone Number	:	409-948-8577
Fax Number	:	409-948-8578

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

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	07/08/2007

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