Individual
CHRISTOPHER J SEAGRAVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, SCS, ATC, CSCS
Contact information
Practice address
533 S RIVERSHORE LN, STE 120, EAGLE, ID 83616-4979
(208) 938-8020
(208) 938-8016
Mailing address
7979 W RIFLEMAN ST, BOISE, ID 83704-9066
(208) 938-8020
(208) 938-8016
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT2566
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
118290
DEPT OF LABOR & INDUSTRIE
WA
05
—
1821101064
—
ID
01
—
60017398
RAILROAD MEDICARE
WA
05
—
8334195
—
WA
01
—
8923419
CRIME VICTIMS
WA
01
—
A005
TRICARE
WA
01
—
SE5492
REGENCE BLUE SHIELD
WA
Enumeration date
08/15/2006
Last updated
11/03/2016
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