Basic Information
| Provider Information | |||||||||
| NPI: | 1184083313 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SEYMOUR | ||||||||
| FirstName: | MARY | ||||||||
| MiddleName: | |||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2421 VILLA WEST DR | ||||||||
| Address2: | |||||||||
| City: | FINDLAY | ||||||||
| State: | OH | ||||||||
| PostalCode: | 458400819 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4197885343 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2101 GREENDALE AVE | ||||||||
| Address2: | |||||||||
| City: | FINDLAY | ||||||||
| State: | OH | ||||||||
| PostalCode: | 458407160 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4194223978 | ||||||||
| FaxNumber: | 4194223928 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/16/2016 | ||||||||
| LastUpdateDate: | 02/16/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | 1439 | OH | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.