Provider Demographics
NPI:1194915256
Name:CONARD, SETH TYLER (DC)
Entity type:Individual
Prefix:
First Name:SETH
Middle Name:TYLER
Last Name:CONARD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11906 I ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68137-1244
Mailing Address - Country:US
Mailing Address - Phone:402-506-9696
Mailing Address - Fax:402-986-6961
Practice Address - Street 1:11906 I ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137-1244
Practice Address - Country:US
Practice Address - Phone:402-506-9696
Practice Address - Fax:402-986-6961
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-25
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038011545111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor