Provider Demographics
NPI:1972352961
Name:SIEBERT, REMINGTON (DC)
Entity type:Individual
Prefix:DR
First Name:REMINGTON
Middle Name:
Last Name:SIEBERT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 792
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:MO
Mailing Address - Zip Code:65340-0792
Mailing Address - Country:US
Mailing Address - Phone:660-886-7135
Mailing Address - Fax:
Practice Address - Street 1:754 S ODELL AVE
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MO
Practice Address - Zip Code:65340-2504
Practice Address - Country:US
Practice Address - Phone:660-886-7134
Practice Address - Fax:660-886-7135
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-14
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024016232111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor