Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 273092 | OR |
NPI | 1386807972 |
---|---|
Provider Name | Brent S. Seifert |
First Address | Salem, OR 97301-4342 |
Second Address | Salem, OR 97301-4342 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2008 |
Last Update Date | 28/03/2014 |