MEDICARE: DR. MITCHELL ALLEN SIEGAL DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CH0007014	FL

General Provider Information

NPI Number	:	1922160753
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MITCHELL ALLEN SIEGAL DC

Provider Business Mailing Address
First Line	:	8280 BOB O LINK DR
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33412-2406
Country	:	US
Telephone Number	:	561-624-3003
Fax Number	:	561-624-4349

Provider Business Practice Location Address
First Line	:	5600 PGA BLVD
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418-3900
Country	:	US
Telephone Number	:	561-624-3003
Fax Number	:	561-624-4349

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2006
Last Update Date	:	07/08/2007

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