Provider Demographics
NPI:1003034356
Name:SIEMERS, PAUL N (DC)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:N
Last Name:SIEMERS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 DEL LN
Mailing Address - Street 2:
Mailing Address - City:FARIBAULT
Mailing Address - State:MN
Mailing Address - Zip Code:55021-7015
Mailing Address - Country:US
Mailing Address - Phone:507-412-1293
Mailing Address - Fax:
Practice Address - Street 1:1130 DEL LN
Practice Address - Street 2:
Practice Address - City:FARIBAULT
Practice Address - State:MN
Practice Address - Zip Code:55021-7015
Practice Address - Country:US
Practice Address - Phone:507-412-1293
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2013-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3749111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNCO3462Medicare ID - Type Unspecified