Basic Information
| Provider Information | |||||||||
| NPI: | 1972822435 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | TRENTON P SEWELL DC PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7620 HILLSIDE RD STE 100 | ||||||||
| Address2: | |||||||||
| City: | AMARILLO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 791198360 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8063512722 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7620 HILLSIDE RD STE 100 | ||||||||
| Address2: | |||||||||
| City: | AMARILLO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 791198360 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8063512722 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/24/2010 | ||||||||
| LastUpdateDate: | 05/24/2010 | ||||||||
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| AuthorizedOfficialLastName: | SEWELL | ||||||||
| AuthorizedOfficialFirstName: | TRENTON | ||||||||
| AuthorizedOfficialMiddleName: | PAUL | ||||||||
| AuthorizedOfficialTitleorPosition: | DOCTOR | ||||||||
| AuthorizedOfficialTelephone: | 8063512722 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | D.C. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111N00000X | 11047 | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Chiropractic Providers | Chiropractor |
No ID Information.