Healthcare Provider Details

I. General information

NPI: 1124442553
Provider Name (Legal Business Name): AMBER HILLIGAS DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: AMBER JACKSON

II. Dates (important events)

Enumeration Date: 02/05/2014
Last Update Date: 12/19/2023
Certification Date: 12/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

929 S LOCUST ST
GRAND ISLAND NE
68801-6751
US

IV. Provider business mailing address

929 S LOCUST ST
GRAND ISLAND NE
68801-6751
US

V. Phone/Fax

Practice location:
  • Phone: 308-382-9700
  • Fax:
Mailing address:
  • Phone: 308-382-9700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number3146
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: