Provider Demographics
NPI:1538383989
Name:SEIGLER, LAURENCE CALVIN (DC)
Entity type:Individual
Prefix:DR
First Name:LAURENCE
Middle Name:CALVIN
Last Name:SEIGLER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:194 N COUNTRY CLUB RD
Mailing Address - Street 2:P.O.BOX 950996
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-3240
Mailing Address - Country:US
Mailing Address - Phone:407-323-6626
Mailing Address - Fax:407-322-5994
Practice Address - Street 1:194 N COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-3240
Practice Address - Country:US
Practice Address - Phone:407-323-6626
Practice Address - Fax:407-322-5994
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0002956111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL88311OtherBLUE CROSS BLUE SHIELD
FLT95210Medicare UPIN