Basic Information
Provider Information
NPI: 1922632447
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SEAY
FirstName: SETH
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1548 S 1500 E
Address2:  
City: SALT LAKE CITY
State: UT
PostalCode: 841052819
CountryCode: US
TelephoneNumber: 3854957515
FaxNumber:  
Practice Location
Address1: 2000 CIRCLE OF HOPE DR # 1950
Address2:  
City: SALT LAKE CITY
State: UT
PostalCode: 841125550
CountryCode: US
TelephoneNumber: 8015877000
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/24/2020
LastUpdateDate: 11/23/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/23/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X10391360-2401UTY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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