Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner |
NPI | 1043462856 |
---|---|
Provider Name | Roger W Seward |
First Address | North Hollywood, CA 91601-5604 |
Second Address | Van Nuys, CA 91405-4038 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2008 |
Last Update Date | 14/10/2008 |