Provider Demographics
NPI:1073533204
Name:SIEGFRIED, KAREN LEMAR (ATC/L)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:LEMAR
Last Name:SIEGFRIED
Suffix:
Gender:F
Credentials:ATC/L
Other - Prefix:MISS
Other - First Name:KAREN
Other - Middle Name:ALICE
Other - Last Name:LEMAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC/L
Mailing Address - Street 1:1113 AVERETT LN
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-7131
Mailing Address - Country:US
Mailing Address - Phone:901-737-7575
Mailing Address - Fax:
Practice Address - Street 1:1458 W POPLAR AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:COLLIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:38017-0630
Practice Address - Country:US
Practice Address - Phone:901-759-5491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN00000007412255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer