Individual
MARK SIEGEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
508 N ACADIA RD, THIBODAUX, LA 70301-4862
(985) 448-5888
Mailing address
PO BOX 676, THIBODAUX, LA 70302-0676
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
261QP2000X
Physical Therapy Clinic/Center
PT03218
LA
Other
Enumeration date
07/17/2007
Last updated
04/03/2025
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