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Individual

DAVID A SEYMOUR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
10050 BASSETT RD, ATHENS, OH 45701-3626
(740) 593-3890
Mailing address
PO BOX 724, ATHENS, OH 45701-0724

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
169750
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2314525
OH
05
2864002
OH
Enumeration date
02/22/2019
Last updated
02/22/2019
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