Individual
LIBORIO L LIRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3501 DOUGLAS DR N, CRYSTAL, MN 55422-2480
(764) 535-9601
(763) 535-5601
Mailing address
226 CENTRAL AVE, OSSEO, MN 55369-1245
(763) 425-2117
(763) 425-3935
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
20943
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
843570700
—
MN
Enumeration date
06/24/2005
Last updated
02/01/2013
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