Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT28504 | FL |
N | 2251N0400X | Physical Therapist - Neurology | PT28504 | FL |
NPI | 1679905095 |
---|---|
Provider Name | Dr. Bryant Aubrey Seamon |
First Address | Tampa, FL 33647-2671 |
Second Address | Tampa, FL 33612-4745 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2013 |
Last Update Date | 09/08/2013 |