Provider Demographics
NPI:1235237652
Name:SIEGEL-SOBOCINSKI, KRISTEN LYNN (DC)
Entity Type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:LYNN
Last Name:SIEGEL-SOBOCINSKI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:KRISTEN
Other - Middle Name:LYNN
Other - Last Name:SIEGEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:100 EUROPA DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-2357
Mailing Address - Country:US
Mailing Address - Phone:919-929-4244
Mailing Address - Fax:919-929-4245
Practice Address - Street 1:100 EUROPA DR
Practice Address - Street 2:SUITE 300
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-2357
Practice Address - Country:US
Practice Address - Phone:919-929-4244
Practice Address - Fax:919-929-4245
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2298111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2450984Medicare ID - Type Unspecified