Basic Information
| Provider Information | |||||||||
| NPI: | 1992114144 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SEABUL | ||||||||
| FirstName: | MEAGEN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7250 FRANCE AVE S | ||||||||
| Address2: | |||||||||
| City: | EDINA | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554354305 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9522852840 | ||||||||
| FaxNumber: | 9522852830 | ||||||||
| Practice Location | |||||||||
| Address1: | 7250 FRANCE AVE S | ||||||||
| Address2: | |||||||||
| City: | EDINA | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554354305 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9522852840 | ||||||||
| FaxNumber: | 9522852830 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/12/2014 | ||||||||
| LastUpdateDate: | 08/12/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 104638 | MN | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.