Individual
MR. GARY ALAN LISCUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.AC.
Contact information
Practice address
1028 8TH ST, GREELEY, CO 80631-1101
(970) 356-9803
Mailing address
1028 8TH ST, GREELEY, CO 80631
(970) 356-9803
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
142
CO
Other
Enumeration date
01/16/2009
Last updated
01/16/2009
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