Individual
DR. GRACE MARIE LIDL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
301 ANDREWS AVE., LYSTER ARMY HEALTH CLINIC, FORT RUCKER, AL 36362-5333
(334) 255-7040
(334) 255-7716
Mailing address
301 ANDREWS AVE., LYSTER ARMY HEALTH CLINIC, FORT RUCKER, AL 36362-5333
(334) 255-7040
(334) 255-7716
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
—
—
Other
Enumeration date
09/04/2007
Last updated
03/02/2017
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