Individual
THOMAS W LIESTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C.
Contact information
Practice address
1700 HIGHWAY 25 N, BUFFALO, MN 55313-1930
(763) 682-1313
Mailing address
1700 HIGHWAY 25 N, BUFFALO, MN 55313-1930
(763) 682-1313
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
TEMP 987,
MN
Other
Enumeration date
06/18/2007
Last updated
07/08/2007
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