| Doctor Name: | NICOLE SAMANTHA SIEGEL |
| NPI Number: | 1003133232 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 0011037 |
| Business Practice Address: | 300 South Mahoney Drive Telluride, CO - 81435 |
| Business Phone Number: | 9707281888 |
| Business Fax Number: | 9703694671 |
| Mailing Address: | Po Box 3178, TELLURIDE |
| State: | CO |
| Postal Code: | 814353178 |
| Phone Number: | 9707281888 |
| Fax Number: | 9703694671 |
| NPI Enumeration Date: | 04/28/2010 |
| NPI Last Update Date: | 12/11/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251X0800X |
| License Number: | 0011037 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Orthopedic |
| Taxonomy Definition: | |