Provider Demographics
NPI:1306968425
Name:SEITZ, JON R (PT)
Entity type:Individual
Prefix:MR
First Name:JON
Middle Name:R
Last Name:SEITZ
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1331 NW 30TH ST
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330-1850
Mailing Address - Country:US
Mailing Address - Phone:541-752-0028
Mailing Address - Fax:
Practice Address - Street 1:1046 6TH AVE S.W.
Practice Address - Street 2:PHYSICAL REHABILITATION DEPARTMENT
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97321-1999
Practice Address - Country:US
Practice Address - Phone:541-812-4160
Practice Address - Fax:541-812-4614
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0660225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist