Provider Demographics
NPI:1508819160
Name:POSTMA, NATHAN TYLER (MA, ATC)
Entity Type:Individual
Prefix:MR
First Name:NATHAN
Middle Name:TYLER
Last Name:POSTMA
Suffix:
Gender:M
Credentials:MA, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:923 NE 43RD ST
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50021-6701
Mailing Address - Country:US
Mailing Address - Phone:515-231-8955
Mailing Address - Fax:
Practice Address - Street 1:1800 S 4TH ST
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50011-1510
Practice Address - Country:US
Practice Address - Phone:515-231-8955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0013602255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer