Individual
LIESEL JAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
4617 W 20TH ST UNIT A, GREELEY, CO 80634-3207
(970) 352-9022
Mailing address
2001 ROSEN DR APT 6-301, FORT COLLINS, CO 80528-2013
(937) 760-5181
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0014684
CO
Other
Enumeration date
06/23/2017
Last updated
06/23/2017
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