Individual
DR. THADDEUS R LIEBIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT,ATC
Contact information
Practice address
401 W DARLENE ST, HARTINGTON, NE 68739-4510
(402) 254-3985
(402) 254-3963
Mailing address
401 W DARLENE ST, PO BOX 107, HARTINGTON, NE 68739-4510
(402) 254-3985
(402) 254-3963
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
1668
NE
225100000X
Physical Therapist
1065
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5834080
—
SD
Enumeration date
08/09/2005
Last updated
07/29/2011
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