Provider Demographics
NPI:1467822239
Name:SEN CHIROPRACTIC, INC
Entity Type:Organization
Organization Name:SEN CHIROPRACTIC, INC
Other - Org Name:THE SPINE CHIROPRACTIC AND WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:708-935-7199
Mailing Address - Street 1:404 GOLDENWEST ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-2637
Mailing Address - Country:US
Mailing Address - Phone:708-935-7199
Mailing Address - Fax:
Practice Address - Street 1:808 ADAMS AVE.
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648
Practice Address - Country:US
Practice Address - Phone:949-783-8454
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-05
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32521111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty