Individual
MARK SEYMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
860 US HIGHWAY 90 E, BALDWIN, FL 32234-1727
(904) 615-3121
Mailing address
860 US HIGHWAY 90 E, BALDWIN, FL 32234-1727
(904) 615-3121
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5173235
FL
Other
Enumeration date
12/14/2016
Last updated
12/14/2016
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