Provider Demographics
NPI:1063886828
Name:SEIBERT, LEE
Entity type:Individual
Prefix:
First Name:LEE
Middle Name:
Last Name:SEIBERT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1960 GRAND AVE
Mailing Address - Street 2:STE. 7
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50265-4218
Mailing Address - Country:US
Mailing Address - Phone:515-225-2242
Mailing Address - Fax:515-225-2697
Practice Address - Street 1:1960 GRAND AVE
Practice Address - Street 2:STE. 7
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50265-4218
Practice Address - Country:US
Practice Address - Phone:515-225-2242
Practice Address - Fax:515-225-2697
Is Sole Proprietor?:No
Enumeration Date:2015-11-17
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001058237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist