Individual
STACY L LIDDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
911 W ANDERSON LN, STE 117, AUSTIN, TX 78757-1501
(512) 467-1100
(512) 467-1101
Mailing address
3201 BENBROOK DR, AUSTIN, TX 78757-6803
(512) 420-9362
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
1105211
TX
225700000X
Massage Therapist
MT022197
TX
Other
Enumeration date
07/04/2006
Last updated
01/14/2009
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