Provider Demographics
NPI:1548481591
Name:SIEBERT MOBILITY, INC.
Entity type:Organization
Organization Name:SIEBERT MOBILITY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MGR
Authorized Official - Prefix:
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:MATTSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-986-3010
Mailing Address - Street 1:3450 SE MIEHE DRIVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:GRIMES
Mailing Address - State:IA
Mailing Address - Zip Code:50111
Mailing Address - Country:US
Mailing Address - Phone:515-986-3010
Mailing Address - Fax:515-986-3108
Practice Address - Street 1:3450 SE MIEHE DRIVE
Practice Address - Street 2:SUITE 1
Practice Address - City:GRIMES
Practice Address - State:IA
Practice Address - Zip Code:50111
Practice Address - Country:US
Practice Address - Phone:515-986-3010
Practice Address - Fax:515-986-3108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WV0202XOther Service ProvidersContractorVehicle ModificationsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0729624Medicaid