Organization
LIBERTY CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDY CURTIS LEHMAN MD (OWNER)
(219) 866-4135
Entity
Organization
Contact information
Practice address
1103 E GRACE ST, RENSSELAER, IN 47978-3210
(219) 866-4135
(219) 866-0803
Mailing address
1103 E GRACE ST, RENSSELAER, IN 47978-3210
(219) 866-4135
(219) 866-0803
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1912388414
INDIVIDUAL NPI
—
05
—
300057753
—
IN
Enumeration date
09/02/2021
Last updated
06/02/2022
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