Basic Information
Provider Information
NPI: 1003001926
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SEINA
FirstName: CRAIG
MiddleName: PATRICK
NamePrefix:  
NameSuffix:  
Credential: L.M.T. N.M.T. M.F.T.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 9015 ARBOR ST.
Address2: SUITE 118
City: OMAHA
State: NE
PostalCode: 681242056
CountryCode: US
TelephoneNumber: 4023989500
FaxNumber: 4023439200
Practice Location
Address1: 9015 ARBOR ST
Address2: SUITE 118
City: OMAHA
State: NE
PostalCode: 681242056
CountryCode: US
TelephoneNumber: 4023989500
FaxNumber: 4023439200
Other Information
ProviderEnumerationDate: 09/13/2007
LastUpdateDate: 09/13/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225700000X507NEY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist 

No ID Information.


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