Individual
CHARISE R LIEBHART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
321 BUTTS AVE, TOMAH, WI 54660-1412
(608) 372-2181
(608) 374-0334
Mailing address
321 BUTTS AVE, TOMAH, WI 54660-1412
(608) 372-2181
(608) 374-0334
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
6213-026
WI
Other
Enumeration date
01/24/2018
Last updated
01/24/2018
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