Provider Demographics
NPI:1922160753
Name:SIEGAL, MITCHELL ALLEN (DC)
Entity Type:Individual
Prefix:DR
First Name:MITCHELL
Middle Name:ALLEN
Last Name:SIEGAL
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 1:8280 BOB O LINK DR
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33412-2406
Mailing Address - Country:US
Mailing Address - Phone:561-624-3003
Mailing Address - Fax:561-624-4349
Practice Address - Street 1:5600 PGA BLVD
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33418-3900
Practice Address - Country:US
Practice Address - Phone:561-624-3003
Practice Address - Fax:561-624-4349
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0007014111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor