Individual
JULIE LIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPM, LAT, ATC
Contact information
Practice address
2303 MEADOWSWEET CT, FORT WAYNE, IN 46808-1694
(260) 413-0428
Mailing address
2303 MEADOWSWEET CT, FORT WAYNE, IN 46808-1694
(260) 413-0428
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36001984A
IN
Other
Enumeration date
03/04/2016
Last updated
09/11/2024
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