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1265103006
TRAVIS MICHAEL SEDDON
BENTON, IL
NPI
1265103006
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: IL 209024033)
Enumeration Date
2021-09-22
Last Update Date
2024-08-02
Business Address
TRAVIS MICHAEL SEDDON NP-C
203 BAILEY LN STE 1
BENTON, IL 62812-2266
Phone number: 618-438-5670
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Mailing Address
TRAVIS MICHAEL SEDDON NP-C
PO BOX 3988
CARBONDALE, IL 62902-3988
Phone number:
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MAIN STREET MEDICAL CLINIC LLC