Individual
LARRY LEE LIBBEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CO
Contact information
Practice address
7735 W JEFFERSON BLVD, SUITE C, FORT WAYNE, IN 46804-4135
(260) 483-5219
(260) 484-2291
Mailing address
7735 W JEFFERSON BLVD, SUITE C, FORT WAYNE, IN 46804-4135
(260) 483-5219
(260) 484-2291
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
CO004903
IN
Other
Enumeration date
07/21/2006
Last updated
03/09/2017
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