Provider Demographics
NPI:1962632034
Name:GEORGE R. SIEGFRIED, D.C., P.C.
Entity Type:Organization
Organization Name:GEORGE R. SIEGFRIED, D.C., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:SIEGFRIED
Authorized Official - Suffix:
Authorized Official - Credentials:DC, PC
Authorized Official - Phone:503-472-6550
Mailing Address - Street 1:301 NE DUNN PL
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97128-9077
Mailing Address - Country:US
Mailing Address - Phone:503-472-6550
Mailing Address - Fax:
Practice Address - Street 1:301 NE DUNN PL
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128-9077
Practice Address - Country:US
Practice Address - Phone:503-472-6550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-22
Last Update Date:2009-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1887111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty