Provider Demographics
NPI:1528255981
Name:SEAVER, BRENT L (DC)
Entity type:Individual
Prefix:
First Name:BRENT
Middle Name:L
Last Name:SEAVER
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 1:2210 WRIGHTSVILLE AVE
Mailing Address - Street 2:STE 3C
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-2575
Mailing Address - Country:US
Mailing Address - Phone:910-392-3100
Mailing Address - Fax:910-763-2884
Practice Address - Street 1:2210 WRIGHTSVILLE AVE
Practice Address - Street 2:STE 3C
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-2575
Practice Address - Country:US
Practice Address - Phone:910-392-3100
Practice Address - Fax:910-763-2884
Is Sole Proprietor?:No
Enumeration Date:2007-10-01
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3035111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC203446500OtherDEPT OF LABOR
NC085GPOtherBCBS
NC007432471OtherAETNA
NCU88622Medicare UPIN
NC085GPOtherBCBS