Provider Demographics
NPI:1356547863
Name:SEILER, JON (PT)
Entity type:Individual
Prefix:MR
First Name:JON
Middle Name:
Last Name:SEILER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14285 CUCKLE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:OH
Mailing Address - Zip Code:43402-9549
Mailing Address - Country:US
Mailing Address - Phone:419-354-0513
Mailing Address - Fax:
Practice Address - Street 1:2920 CHERRY ST
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43608-1716
Practice Address - Country:US
Practice Address - Phone:419-242-7458
Practice Address - Fax:419-242-6514
Is Sole Proprietor?:No
Enumeration Date:2007-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH011248225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist