Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 15-1478 | AZ |
NPI | 1104218411 |
---|---|
Provider Name | Dr. Jeffrey Michael Seder |
First Address | Gilbert, AZ 85295-2817 |
Second Address | Gilbert, AZ 85295-2817 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2015 |
Last Update Date | 23/02/2015 |