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Individual

MR. JOHN LIDDELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHYSICAL THERAPIST

Contact information

Practice address
1516 W MEQUON RD, STE 201, MEQUON, WI 53092-3264
(262) 241-8402
(262) 241-8403
Mailing address
1516 W MEQUON RD, STE 201, MEQUON, WI 53092-3264
(262) 241-8402
(262) 241-8403

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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