Individual
CARMEN A LIEBELT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
711 W ADAMS ST, BLACK RIVER FALLS, WI 54615-9108
(715) 284-1330
(715) 284-1398
Mailing address
711 W ADAMS ST, BLACK RIVER FALLS, WI 54615-9108
(715) 284-1330
(715) 284-1398
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
9536024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40374100
—
WI
01
—
9536024
WISCONSIN STATE LICENSE
WI
Enumeration date
12/28/2006
Last updated
07/09/2007
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