Provider Demographics
NPI:1548685233
Name:SEYMOUR, GREGORY (OTR/L)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:
Last Name:SEYMOUR
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7745 DREXEL DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63130-2121
Mailing Address - Country:US
Mailing Address - Phone:314-471-8939
Mailing Address - Fax:
Practice Address - Street 1:7745 DREXEL DR
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63130-2121
Practice Address - Country:US
Practice Address - Phone:314-471-8939
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-04
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014006537225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist