Individual
SHIRLEE SUE SEATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1429 S AVENUE D, PORTALES, NM 88130-6837
(505) 356-4888
(505) 359-3108
Mailing address
1612 S MAIN AVE, PORTALES, NM 88130-7331
(505) 356-1631
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1377
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006
HCH ID
NM
01
—
2387
LOVELACE ID
NM
01
—
NM00Q005
BLUE CROSS ID
NM
01
—
PROVP16520
MOLINA ID
NM
Enumeration date
08/24/2006
Last updated
09/05/2013
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