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General NPI Number Information
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NPI Number | 1679017362
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Entity Type | Organization
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Legal Business Name | SEIBERT MOBILE OPTOMETRY LLC
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Dates
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Enumeration Date | 12/14/2016
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Last Update Date | 01/27/2026
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Provider Practice Location Address
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Address Line | 221 BOLIVAR ST
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City | JEFFERSON CITY
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State | MO
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Zip | 65101-1572
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Country | US
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Telephone | 502-579-1797
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Fax | 502-996-8282
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Provider Business Mailing Address
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Address Line | 221 BOLIVAR ST
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City | JEFFERSON CITY
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State | MO
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Zip | 65101-1572
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Country | US
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Telephone | 502-579-1797
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Fax | 502-996-8282
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Authorized Official
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Title or Position | OWNER
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Name | DANIEL SEIBERT
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Credential | OD
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Telephone | 502-579-1797
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | T02387
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License Number State | MO
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