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General NPI Number Information
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NPI Number | 1376741645
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Entity Type | Individual
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Provider Name | JUDITH ANNE SIEVERS LMT NMT
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Gender | Female
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Dates
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Enumeration Date | 07/06/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 11673 SAGUARO BLVD SMITH FAMILY CHIROPRACTIC
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City | FOUNTAIN HILLS
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State | AZ
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Zip | 85268
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Country | US
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Telephone | 480-235-0770
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 17927
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City | FOUNTAIN HILLS
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State | AZ
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Zip | 85269
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Country | US
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Telephone | 480-235-0770
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT 03185P
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License Number State | AZ
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