Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 1062487 | TX |
N | 2251G0304X | Physical Therapist - Geriatrics | 1062487 | TX |
N | 2251N0400X | Physical Therapist - Neurology | 1062487 | TX |
N | 2251P0200X | Physical Therapist - Pediatrics | 1062487 | TX |
NPI | 1083859136 |
---|---|
Provider Name | Sandra L Seawell |
First Address | Fort Worth, TX 76107-6808 |
Second Address | Fort Worth, TX 76107-6808 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/12/2008 |
Last Update Date | 03/12/2008 |