Provider Demographics
NPI:1386812618
Name:SENECA CHIROPRACTIC & WELLNESS CENTER, LLC
Entity type:Organization
Organization Name:SENECA CHIROPRACTIC & WELLNESS CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTINA
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:HEIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:785-336-6222
Mailing Address - Street 1:514 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SENECA
Mailing Address - State:KS
Mailing Address - Zip Code:66538-1928
Mailing Address - Country:US
Mailing Address - Phone:785-336-6222
Mailing Address - Fax:785-336-6224
Practice Address - Street 1:514 MAIN ST
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:KS
Practice Address - Zip Code:66538-1928
Practice Address - Country:US
Practice Address - Phone:785-336-6222
Practice Address - Fax:785-336-6224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-20
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-04900111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS0000062496OtherBCBS
KS200550600AMedicaid