Provider Demographics
NPI:1326711300
Name:LIGTENBERG, NATALIE (ATC)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:LIGTENBERG
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4409 W 63RD ST
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66208-1508
Mailing Address - Country:US
Mailing Address - Phone:208-749-0504
Mailing Address - Fax:
Practice Address - Street 1:4409 W 63RD ST
Practice Address - Street 2:
Practice Address - City:PRAIRIE VILLAGE
Practice Address - State:KS
Practice Address - Zip Code:66208-1508
Practice Address - Country:US
Practice Address - Phone:208-749-0504
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-27
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer