=====================================================
General NPI Number Information
=====================================================
NPI Number | 1336402288
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SENECHAL FAMILY CHIROPRACTIC, PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/15/2012
-----------------------------------------------------
Last Update Date | 06/15/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 30802 LYON CENTER DR E
-----------------------------------------------------
City | NEW HUDSON
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48165-8582
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 586-337-6823
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 30802 LYON CENTER DR E
-----------------------------------------------------
City | NEW HUDSON
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48165-8582
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 586-337-6823
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DOCTOR
-----------------------------------------------------
Name | ALISHA SENECHAL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 586-337-6823
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111NP0017X
-----------------------------------------------------
Taxonomy Name | Pediatric Chiropractor
-----------------------------------------------------
License Number | 2301009669
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------