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General NPI Number Information
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NPI Number | 1396089728
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Entity Type | Organization
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Legal Business Name | EASTLAND CHIROPRACTIC, P.A
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Dates
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Enumeration Date | 11/26/2012
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Last Update Date | 11/26/2012
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Provider Practice Location Address
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Address Line | 1126 EASTLAND DR N STE 300
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City | TWIN FALLS
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State | ID
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Zip | 83301-8951
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Country | US
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Telephone | 208-734-7077
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Fax | 208-734-7101
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Provider Business Mailing Address
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Address Line | 1126 EASTLAND DR N STE 300
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City | TWIN FALLS
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State | ID
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Zip | 83301-8951
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Country | US
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Telephone | 208-734-7077
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Fax | 208-734-7101
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Authorized Official
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Title or Position | OWNER
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Name | DR. NOEL SENECAL
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Credential | D.C., C.I.R.S
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Telephone | 208-734-7077
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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