Provider Demographics
NPI:1639474893
Name:SIEGEL, DAVID ALAN (DC CCN DACBN)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ALAN
Last Name:SIEGEL
Suffix:
Gender:M
Credentials:DC CCN DACBN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:951 WORTHINGTON WOODS LOOP RD
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-5743
Mailing Address - Country:US
Mailing Address - Phone:614-431-0555
Mailing Address - Fax:614-431-0444
Practice Address - Street 1:951 WORTHINGTON WOODS LOOP RD
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-5743
Practice Address - Country:US
Practice Address - Phone:614-431-0555
Practice Address - Fax:614-431-0444
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-20
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1007111NN1001X
FL4366111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition