Provider Demographics
NPI:1699761262
Name:SEELEY, TIMOTHY SCOTT (RPH)
Entity type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:SCOTT
Last Name:SEELEY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1118 BARROWS RD
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:WY
Mailing Address - Zip Code:82435-9354
Mailing Address - Country:US
Mailing Address - Phone:307-754-8018
Mailing Address - Fax:
Practice Address - Street 1:777 AVENUE H
Practice Address - Street 2:PHARMACY DEPARTMENT
Practice Address - City:POWELL
Practice Address - State:WY
Practice Address - Zip Code:82435-2260
Practice Address - Country:US
Practice Address - Phone:307-754-1279
Practice Address - Fax:307-754-7732
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY2365183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist