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Individual

ELICIA A LIEBE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4733 W MONTANA ST, MILWAUKEE, WI 53219-3375
(414) 702-9488
Mailing address
4733 W MONTANA ST, MILWAUKEE, WI 53219-3375
(414) 702-9488

Taxonomy

Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary

Other

Enumeration date
09/26/2020
Last updated
09/26/2020
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