Individual
TREVOR MATTHEW LIECHTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8966 SPRING VIOLET PL, ZIONSVILLE, IN 46077-7506
(317) 797-1825
Mailing address
8966 SPRING VIOLET PL, ZIONSVILLE, IN 46077-7506
(317) 797-1825
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
10/28/2019
Last updated
10/28/2019
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