Provider Demographics
NPI:1326286899
Name:ZIEGLER, MICHELLE ANDAYA
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ANDAYA
Last Name:ZIEGLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:MICHELLE
Other - Last Name:ZIEGLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:532 TALLENT CT
Mailing Address - Street 2:
Mailing Address - City:ELLSWORTH AFB
Mailing Address - State:SD
Mailing Address - Zip Code:57706-1717
Mailing Address - Country:US
Mailing Address - Phone:605-791-1259
Mailing Address - Fax:
Practice Address - Street 1:532 TALLENT CT
Practice Address - Street 2:
Practice Address - City:ELLSWORTH AFB
Practice Address - State:SD
Practice Address - Zip Code:57706-1717
Practice Address - Country:US
Practice Address - Phone:605-791-1259
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-21
Last Update Date:2009-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL21297225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist