Provider Demographics
NPI:1447660691
Name:STROMBERG, SENECCA ALLRED (ATC, LAT)
Entity type:Individual
Prefix:
First Name:SENECCA
Middle Name:ALLRED
Last Name:STROMBERG
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:SENECCA
Other - Middle Name:
Other - Last Name:ALLRED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC, LAT
Mailing Address - Street 1:2673 S AVENUE A
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-7102
Mailing Address - Country:US
Mailing Address - Phone:928-287-3010
Mailing Address - Fax:
Practice Address - Street 1:4100 W 20TH ST
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-4800
Practice Address - Country:US
Practice Address - Phone:928-502-5700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-28
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ11252255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer