| Doctor Name: | GARY R SENA |
| NPI Number: | 1285785782 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | PA146 |
| Business Practice Address: | 420 E 4th N Rexburg, ID - 834405390 |
| Business Phone Number: | 2083569100 |
| Business Fax Number: | 2083569499 |
| Mailing Address: | 420 E 4th N, REXBURG |
| State: | ID |
| Postal Code: | 834405390 |
| Phone Number: | 2083569100 |
| Fax Number: | 2083569499 |
| NPI Enumeration Date: | 01/13/2007 |
| NPI Last Update Date: | 09/11/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | PA146 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | ID |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |