Loren Leiseberg

NPI #1902254097 in Normal, Illinois

Provider Information

NPI Number: 1902254097
Entity Type: Individual
Name: Loren Leiseberg
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pharmacist
Enumeration Date: May 30, 2016
Last Updated: May 30, 2016

Practice Location

Address: 901 S COTTAGE AVE
City: Normal
State: Illinois
ZIP Code: 61761-3302
Phone: (309) 454-6080

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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