Individual
MRS. NICOLE MARIE SIEG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2400 COLLEGE AVE, GOSHEN, IN 46528-5010
(574) 533-0351
Mailing address
21814 ANGELA DR, GOSHEN, IN 46526-9431
(574) 370-3785
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06003382A
IN
Other
Enumeration date
06/03/2008
Last updated
06/03/2008
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