Provider Demographics
NPI:1760565634
Name:ZIEGLER, CATHY (PT, ATC)
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:
Last Name:ZIEGLER
Suffix:
Gender:F
Credentials:PT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2751 2ND AVE N STOP 9013
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58202-9013
Mailing Address - Country:US
Mailing Address - Phone:701-777-4846
Mailing Address - Fax:701-777-2536
Practice Address - Street 1:2751 2ND AVE N STOP 9013
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58202-9013
Practice Address - Country:US
Practice Address - Phone:701-777-4846
Practice Address - Fax:701-777-2536
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND887225100000X
SD422225100000X
ND089-912255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Not Answered2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND54207OtherND ASSISTANCE PT
ND58483Medicaid
ND1013166OtherPREFERRED ONE GROUP # PT
ND1B240HEOtherBCBSMN PT
ND6088OtherBCBSND PT