Individual
EVERT GENE SIEBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
7TH STREET, INDIANA STATE UNIVERSITY, ARENA BUILDING, TERRE HAUTE, IN 47807
(812) 249-9468
Mailing address
630 ELM ST, APT 3, TERRE HAUTE, IN 47807-2046
(812) 249-9468
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
36001269A
IN
Other
Enumeration date
02/14/2006
Last updated
07/08/2007
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