Provider Demographics
NPI:1922174358
Name:LIGHTNER, DONALD (LAC)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:
Last Name:LIGHTNER
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 E SPEEDWAY BLVD STE 114
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-3954
Mailing Address - Country:US
Mailing Address - Phone:520-323-0203
Mailing Address - Fax:
Practice Address - Street 1:3400 E SPEEDWAY BLVD STE 114
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-3954
Practice Address - Country:US
Practice Address - Phone:520-323-0203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0123171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist