Individual
MR. JOHN LIDDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICAL THERAPIST
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
10133
MN
225100000X
Physical Therapist
11987
AZ
225100000X
Physical Therapist
Primary
13065
WI
Other
Enumeration date
01/06/2016
Last updated
05/08/2016
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