Individual
MR. SETH ANDREW STAFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
329 RAINBOW DR, KOKOMO, IN 46902-3869
(765) 455-1700
Mailing address
329 RAINBOW DR, KOKOMO, IN 46902-3869
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06004477A
IN
Other
Enumeration date
01/12/2013
Last updated
01/12/2013
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