Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | PT021141 | PA |
NPI | 1043500580 |
---|---|
Provider Name | Mrs. Laurie Ann Seid |
First Address | Jermyn, PA 18433-1130 |
Second Address | Jermyn, PA 18433-1130 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2011 |
Last Update Date | 18/04/2011 |