Provider Demographics
NPI:1083931851
Name:MITCHINER-SENECAL, POLLY
Entity Type:Individual
Prefix:
First Name:POLLY
Middle Name:
Last Name:MITCHINER-SENECAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:382 ASHEVILLE HWY
Mailing Address - Street 2:
Mailing Address - City:BREVARD
Mailing Address - State:NC
Mailing Address - Zip Code:28712
Mailing Address - Country:US
Mailing Address - Phone:828-877-8600
Mailing Address - Fax:828-877-8606
Practice Address - Street 1:382 ASHEVILLE HIGHWAY
Practice Address - Street 2:
Practice Address - City:BREVARD
Practice Address - State:NC
Practice Address - Zip Code:28712
Practice Address - Country:US
Practice Address - Phone:828-877-8600
Practice Address - Fax:828-877-8606
Is Sole Proprietor?:No
Enumeration Date:2010-05-03
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC19458183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist