Individual
MRS. KACIE RIANNE LISKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
601 W DAVENPORT ST, ELDRIDGE, IA 52748-1168
(563) 343-0395
Mailing address
601 W DAVENPORT ST, ELDRIDGE, IA 52748-1168
(563) 343-0395
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
114799
IA
Other
Enumeration date
06/15/2022
Last updated
06/15/2022
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