Provider Demographics
NPI:1497763833
Name:SEIBERT, DAREL L (DC)
Entity Type:Individual
Prefix:
First Name:DAREL
Middle Name:L
Last Name:SEIBERT
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 1:12418 STATE HIGHWAY 14 N
Mailing Address - Street 2:
Mailing Address - City:CEDAR CREST
Mailing Address - State:NM
Mailing Address - Zip Code:87008-9724
Mailing Address - Country:US
Mailing Address - Phone:505-286-2861
Mailing Address - Fax:
Practice Address - Street 1:12418 STATE HIGHWAY 14 N
Practice Address - Street 2:
Practice Address - City:CEDAR CREST
Practice Address - State:NM
Practice Address - Zip Code:87008-9724
Practice Address - Country:US
Practice Address - Phone:505-286-2861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1615111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor