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General NPI Number Information
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NPI Number | 1558460030
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Entity Type | Individual
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Provider Name | AMY LYNN SENICA OD
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Gender | Female
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 11/17/2008
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Provider Practice Location Address
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Address Line | 522 N NEW BALLAS RD SUITE 113
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City | CREVE COEUR
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State | MO
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Zip | 63141-6857
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Country | US
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Telephone | 314-567-7771
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Fax | 314-567-7774
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Provider Business Mailing Address
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Address Line | 522 N NEW BALLAS RD SUITE 113
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City | CREVE COEUR
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State | MO
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Zip | 63141-6857
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Country | US
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Telephone | 314-567-7771
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Fax | 314-567-7774
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT12536
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 200803421
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License Number State | MO
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