Provider Demographics
NPI:1669679585
Name:LIGHT, NATAUSHA D (DC)
Entity Type:Individual
Prefix:
First Name:NATAUSHA
Middle Name:D
Last Name:LIGHT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1558 AIRPORT RD
Mailing Address - Street 2:SUITE H
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-7952
Mailing Address - Country:US
Mailing Address - Phone:501-767-0900
Mailing Address - Fax:501-767-8430
Practice Address - Street 1:1558 AIRPORT RD
Practice Address - Street 2:SUITE H
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-7952
Practice Address - Country:US
Practice Address - Phone:501-767-0900
Practice Address - Fax:501-767-8430
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1686111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor