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NPI 1588717169

NPI 1588717169 : JOSEPH JOHN SENNEBOGEN SR. DC : MARIETTA, GA

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General NPI Number Information
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    NPI Number           |    1588717169
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    Entity Type          |    Individual 
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    Provider Name        |    JOSEPH JOHN SENNEBOGEN SR. DC
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    01/19/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    3600 DALLAS HWY SW STE 120 
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    City                 |    MARIETTA
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    State                |    GA
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    Zip                  |    30064-1631
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    Country              |    US
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    Telephone            |    770-424-3331
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    Fax                  |    770-424-1161
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Provider Business Mailing Address
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    Address Line         |    948 HOLLAND RD 
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    City                 |    POWDER SPRINGS
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    State                |    GA
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    Zip                  |    30127-4221
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    Country              |    US
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    Telephone            |    770-514-7526
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    Fax                  |    770-424-1161
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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        |    111N00000X
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    Taxonomy Name        |    Chiropractor
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    License Number       |    2773
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    License Number State |    GA
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