Provider Demographics
NPI:1780643114
Name:LININGER, MONICA RAE (ATC)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:RAE
Last Name:LININGER
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 1:4146 LAKE CREST CIR
Mailing Address - Street 2:APARTMENT 3B
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49048-7632
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1903 WEST MICHIGAN AVENUE
Practice Address - Street 2:SPORTS MEDICINE CLINIC
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49008-5445
Practice Address - Country:US
Practice Address - Phone:269-387-3248
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist