Individual
PATRICK LIEBL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
91 FOREST RD, BIG LAKE, MN 55309-9457
(612) 655-5178
Mailing address
91 FOREST RD, BIG LAKE, MN 55309-9457
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/10/2017
Last updated
03/10/2017
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