Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251S0007X | Physical Therapist - Sports | 7540 | SC |
NPI | 1518481605 |
---|---|
Provider Name | Bradley Seger |
First Address | Florence, SC 29501-3904 |
Second Address | Florence, SC 29501-3904 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2017 |
Last Update Date | 31/07/2017 |