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Individual

SHANIA SIEBERT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
102 E RAVINE RD, KINGSPORT, TN 37660-3814
(423) 245-9600
Mailing address
478 BRECKENRIDGE TRCE, KINGSPORT, TN 37663-2988
(816) 341-4236

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
TN

Other

Enumeration date
09/19/2022
Last updated
09/19/2022
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