Provider Demographics
NPI:1437646270
Name:SEDEI & VANIDESTINE INDUSTRIES, LLC
Entity Type:Organization
Organization Name:SEDEI & VANIDESTINE INDUSTRIES, LLC
Other - Org Name:CONCIERGE CHIROPRACTIC & REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:SEDEI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:214-364-0567
Mailing Address - Street 1:2805 NE 131ST AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97230-1721
Mailing Address - Country:US
Mailing Address - Phone:214-364-0567
Mailing Address - Fax:
Practice Address - Street 1:2805 NE 131ST AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97230-1721
Practice Address - Country:US
Practice Address - Phone:214-364-0567
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-17
Last Update Date:2018-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty