MEDICARE: CHAD ANTHONY SEAHORN 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	PT 6868	CO

General Provider Information

NPI Number	:	1831149939
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHAD ANTHONY SEAHORN P.T.

Provider Business Mailing Address
First Line	:	PO BOX 1012
Second Line	:
City	:	CARBONDALE
State	:	CO
Zip	:	81623-1012
Country	:	US
Telephone Number	:	720-218-2731
Fax Number	:	719-347-9311

Provider Business Practice Location Address
First Line	:	868 MELISSA LN
Second Line	:
City	:	CARBONDALE
State	:	CO
Zip	:	81623-2819
Country	:	US
Telephone Number	:	720-218-2731
Fax Number	:

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

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	05/28/2021

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