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1659830974
MICHAEL TANNER LIBSACK
NEW ORLEANS, LA
NPI
1659830974
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2019-03-16
Last Update Date
2021-04-03
Business Address
MICHAEL TANNER LIBSACK DO
1430 TULANE AVE # 8050
NEW ORLEANS, LA 70112-2632
Phone number: 504-988-5904
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Mailing Address
MICHAEL TANNER LIBSACK DO
1430 TULANE AVE # 8050
NEW ORLEANS, LA 70112-2632
Phone number: 504-988-5904
Copy
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