Individual
PATRICIA JOAN LIESEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1320 W MAIN ST, NEWARK, OH 43055-1822
(220) 564-4912
(220) 564-4919
Mailing address
1320 W MAIN ST, NEWARK, OH 43055-1822
(220) 564-4912
(220) 564-4919
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD6788
OH
Other
Enumeration date
01/02/2018
Last updated
01/02/2018
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