Provider Demographics
NPI:1700647005
Name:SEIBEL, JULIE A
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:A
Last Name:SEIBEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6655 ROCKVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BLUE ROCK
Mailing Address - State:OH
Mailing Address - Zip Code:43720-9701
Mailing Address - Country:US
Mailing Address - Phone:614-207-0124
Mailing Address - Fax:
Practice Address - Street 1:6655 ROCKVILLE RD
Practice Address - Street 2:
Practice Address - City:BLUE ROCK
Practice Address - State:OH
Practice Address - Zip Code:43720-9701
Practice Address - Country:US
Practice Address - Phone:614-207-0124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-23
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization