Provider Demographics
NPI:1932363314
Name:SIEGEL CHIROPRACTIC CENTER INC
Entity Type:Organization
Organization Name:SIEGEL CHIROPRACTIC CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:M
Authorized Official - Last Name:SIEGEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-738-0222
Mailing Address - Street 1:PO BOX 740688
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33474-0688
Mailing Address - Country:US
Mailing Address - Phone:561-738-0222
Mailing Address - Fax:561-732-0922
Practice Address - Street 1:4956 LE CHALET BLVD
Practice Address - Street 2:SUITE 15
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33436-1413
Practice Address - Country:US
Practice Address - Phone:561-738-0222
Practice Address - Fax:561-732-0922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-15
Last Update Date:2012-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 8777111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty