Individual
MRS. BARBARA MARIE VAN LIESHOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOTR, ATP
Contact information
Practice address
229 MEADOW CT, JEFFERSON, WI 53549-1184
(920) 674-6339
(920) 674-6345
Mailing address
229 MEADOW CT, JEFFERSON, WI 53549-1184
(920) 674-6069
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
124-027
WI
Other
Enumeration date
03/07/2007
Last updated
10/05/2009
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