Provider Demographics
NPI:1588618607
Name:ABBOTT, SIOBHAN ALISON CONKLYN (DC)
Entity type:Individual
Prefix:DR
First Name:SIOBHAN
Middle Name:ALISON CONKLYN
Last Name:ABBOTT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:SIOBHAN
Other - Middle Name:ALISON
Other - Last Name:CONKLYN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:3777 BRIGGS COVE RD
Mailing Address - Street 2:
Mailing Address - City:HAYES
Mailing Address - State:VA
Mailing Address - Zip Code:23072-2617
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2021A CUNNINGHAM DR
Practice Address - Street 2:SUITE 3
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-3320
Practice Address - Country:US
Practice Address - Phone:757-838-8820
Practice Address - Fax:757-838-8823
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2009-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556420111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor