Provider Demographics
NPI:1336119924
Name:SEIFRIED, MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:SEIFRIED
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 1:7252 N BLACK ROCK TRL
Mailing Address - Street 2:
Mailing Address - City:PARADISE VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85253-2803
Mailing Address - Country:US
Mailing Address - Phone:480-473-8664
Mailing Address - Fax:602-889-5834
Practice Address - Street 1:40 N CENTRAL AVE
Practice Address - Street 2:SUITE #775
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85004-4424
Practice Address - Country:US
Practice Address - Phone:602-889-5833
Practice Address - Fax:602-889-5834
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5497111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ5497OtherSTATE BOARD LICENSE NUMBE