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Liberty Clinic Llc
Multi-Specialty Clinic/Center in Rensselaer, Indiana
NPI 1285302430

Liberty Clinic Llc is a Multi-Specialty Clinic/Center based in Rensselaer, IN and is specialized in Multi-Specialty. Liberty Clinic Llc practices in Rensselaer, IN. The NPI Number for Liberty Clinic Llc is 1285302430 and holds a License No. (Indiana).

The current practice location address for Liberty Clinic Llc is 1103 E Grace St, Rensselaer, IN and can be reached out via phone at 219-866-4135 and via fax at 219-866-0803.

Location: 1103 E Grace St, Rensselaer, IN, 47978-3210
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1285302430
Provider Name
Liberty Clinic Llc
Credential
Provider Entity Type
Organization
Address
1103 E Grace St, Rensselaer, IN, 47978-3210
Phone Number
219-866-4135
Fax Number
219-866-0803
Provider Enumeration Date
09/02/2021
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1912388414 01 INDIVIDUAL NPI
300057753 05 IN
institution
Provider Business Practice Location Address Details
Address
1103 E Grace St
City
Rensselaer
State
Indiana
Zip
47978-3210
Phone Number
219-866-4135
Fax Number
219-866-0803
person
Provider Business Mailing Address Details
Address
1103 E Grace St
City
Rensselaer
State
Indiana
Zip
47978-3210
Phone Number
219-866-4135
Fax Number
219-866-0803
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Multi-Specialty
Taxonomy
261QM1300X
License No.
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Definition
Definition to come...
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