Individual
PAYTON LIEGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2817 NEW PINERY RD, PORTAGE, WI 53901-9240
(608) 742-4131
Mailing address
2817 NEW PINERY RD, PORTAGE, WI 53901-9240
(608) 742-4131
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
13107-33
WI
Other
Enumeration date
09/08/2022
Last updated
09/08/2022
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