Individual
PATRICK LIEWER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4020 TIERRA VISTA DR, LAKE HAVASU CITY, AZ 86406-4407
(928) 554-2046
Mailing address
4020 TIERRA VISTA DR, LAKE HAVASU CITY, AZ 86406-4407
(928) 554-2046
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4069715
AZ
Other
Enumeration date
04/25/2013
Last updated
05/06/2013
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