Individual
JULIE LIEBKNECHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS OTR/L
Contact information
Practice address
1401 CEDAR ST NE, GRAND RAPIDS, MI 49503-1375
(616) 486-3900
Mailing address
2585 LAFRANIER RD, TRAVERSE CITY, MI 49686-8972
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201008983
MI
Other
Enumeration date
11/25/2014
Last updated
03/07/2018
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