Provider Demographics
NPI:1316432974
Name:SEAWELL, BRIANNA MARIE (DPT)
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:MARIE
Last Name:SEAWELL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:BRIANNA
Other - Middle Name:
Other - Last Name:LAUER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2922 ALDRICH AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55408-4289
Mailing Address - Country:US
Mailing Address - Phone:952-715-1823
Mailing Address - Fax:
Practice Address - Street 1:4670 PARK NICOLLET AVE SE
Practice Address - Street 2:
Practice Address - City:PRIOR LAKE
Practice Address - State:MN
Practice Address - Zip Code:55372-4119
Practice Address - Country:US
Practice Address - Phone:952-993-4999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-26
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist