Provider Demographics
NPI:1376741645
Name:SIEVERS, JUDITH ANNE (LMT NMT)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:ANNE
Last Name:SIEVERS
Suffix:
Gender:F
Credentials:LMT NMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 17927
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN HILLS
Mailing Address - State:AZ
Mailing Address - Zip Code:85269
Mailing Address - Country:US
Mailing Address - Phone:480-235-0770
Mailing Address - Fax:
Practice Address - Street 1:11673 SAGUARO BLVD
Practice Address - Street 2:SMITH FAMILY CHIROPRACTIC
Practice Address - City:FOUNTAIN HILLS
Practice Address - State:AZ
Practice Address - Zip Code:85268
Practice Address - Country:US
Practice Address - Phone:480-235-0770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMT 03185P225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist