Individual
DANIEL JACOB LIECHTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1970 S RIDGE RD, GREEN BAY, WI 54304-4125
(920) 430-4888
(920) 430-4889
Mailing address
744 S WEBSTER AVE, MEDICAL STAFF SERVICES, GREEN BAY, WI 54301
(920) 433-7860
(920) 433-6090
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
83448-20
WI
Other
Enumeration date
04/25/2016
Last updated
04/18/2024
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