Individual
MICHELLE ELIZABETH LIEPOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
920
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36178700
—
WI
05
—
578693000
—
MN
01
—
650023786
RAILROAD MEDICARE
MN
05
—
ENROLLED
—
IA
05
—
ENROLLED
—
MN
Enumeration date
01/17/2006
Last updated
04/23/2010
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