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General NPI Number Information
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NPI Number | 1497710156
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Entity Type | Individual
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Provider Name | GLEN SIEGEL DC
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Gender | Male
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Dates
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Enumeration Date | 04/18/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 7963 MIRAMAR PKWY
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City | MIRAMAR
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State | FL
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Zip | 33023-5877
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Country | US
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Telephone | 954-966-8770
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Fax | 954-966-8770
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Provider Business Mailing Address
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Address Line | 7963 MIRAMAR PKWY
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City | MIRAMAR
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State | FL
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Zip | 33023-5877
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Country | US
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Telephone | 954-966-8770
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Fax | 954-966-8770
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH0002753
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License Number State | FL
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