Provider Demographics
NPI:1790122869
Name:SIGLE-GEORG, JILL LOREE
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:LOREE
Last Name:SIGLE-GEORG
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 1:1105 MAIN ST # 53
Mailing Address - Street 2:
Mailing Address - City:LA CROSSE
Mailing Address - State:KS
Mailing Address - Zip Code:67548-8404
Mailing Address - Country:US
Mailing Address - Phone:785-222-2323
Mailing Address - Fax:785-514-5353
Practice Address - Street 1:PO BOX 53
Practice Address - Street 2:
Practice Address - City:LA CROSSE
Practice Address - State:KS
Practice Address - Zip Code:67548-0053
Practice Address - Country:US
Practice Address - Phone:785-222-6088
Practice Address - Fax:785-514-5353
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-30
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05546111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor