Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 11047 | TX |
NPI | 1003139353 |
---|---|
Provider Name | Dr. Trenton P Sewell |
First Address | Amarillo, TX 79109-5202 |
Second Address | Amarillo, TX 79109-5202 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/03/2010 |
Last Update Date | 01/03/2010 |