Organization
MITCHELL B. LIESTER, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MITCHELL BRENT LIESTER M.D. (CHAIRMAN/OWNER)
(719) 488-0024
Entity
Organization
Contact information
Practice address
153 WASHINGTON ST STE 103, MONUMENT, CO 80132-9181
(719) 488-0024
(719) 488-6672
Mailing address
PO BOX 302, 153 N. WASHINGTON STREET, SUITE 103, MONUMENT, CO 80132-0302
(719) 488-0024
(719) 488-6672
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
29395
CO
Other
Enumeration date
09/06/2007
Last updated
09/06/2007
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