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NPI 1497209779

NPI 1497209779 : NATALIE LIOGGHIO : WHITMORE LAKE, MI

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General NPI Number Information
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    NPI Number           |    1497209779
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    Entity Type          |    Individual 
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    Provider Name        |    NATALIE LIOGGHIO
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/04/2016
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    Last Update Date     |    08/04/2016
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Provider Practice Location Address
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    Address Line         |    6521 FIELD AVE 
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    City                 |    WHITMORE LAKE
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    State                |    MI
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    Zip                  |    48189-9770
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    Country              |    US
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    Telephone            |    734-216-3339
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 118 
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    City                 |    HAMBURG
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    State                |    MI
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    Zip                  |    48139-0118
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    Country              |    US
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    Telephone            |    734-216-3339
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    247200000X
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    Taxonomy Name        |    Other Technician
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    License Number       |    
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    License Number State |    
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