Provider Demographics
NPI:1790018943
Name:KLIEGER, LISA M (MAC)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:M
Last Name:KLIEGER
Suffix:
Gender:F
Credentials:MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7471 GASSAWAY RD
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:TN
Mailing Address - Zip Code:37190-5107
Mailing Address - Country:US
Mailing Address - Phone:615-653-5949
Mailing Address - Fax:
Practice Address - Street 1:313 W MAIN ST
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:TN
Practice Address - Zip Code:37190-1144
Practice Address - Country:US
Practice Address - Phone:615-653-5949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-04
Last Update Date:2009-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNACU0000000085171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist