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Individual

KRISTIN K. LIETZAU

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
BELOIT CLINIC, 1905 E. HUEBBE PARKWAY, BELOIT, WI 53511-1842
(608) 364-2230
(608) 363-7394
Mailing address
BELOIT CLINIC, 1905 E. HUEBBE PARKWAY, BELOIT, WI 53511-1842
(608) 364-2293
(608) 364-5452

Taxonomy

Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
085.007026
IL
363A00000X
Physician Assistant
085-007026
IL
363A00000X
Physician Assistant
Primary
4671-23
WI

Other

Enumeration date
04/04/2019
Last updated
05/28/2019
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