| Bruce H Lieske, DC | |
|
100 Main Street South, Lonsdale, MN 55046-0162 | |
| (507) 744-5514 | |
| (507) 744-5513 |
| Full Name | Bruce H Lieske |
|---|---|
| Gender | Male |
| Speciality | Chiropractor |
| Location | 100 Main Street South, Lonsdale, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699854513 | NPI | - | NPPES |
| 081322200 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 003501 (Minnesota) | Primary |
| Provider Name | Lieske Chiropractic Pllc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1063874246 PECOS PAC ID: 0244593838 Enrollment ID: O20180412001854 |
| Mailing Address | Practice Location Address |
|---|---|
| Bruce H Lieske, DC 100 Main Street South Po Box 162, Lonsdale, MN 55046-0162 Ph: (507) 744-5514 | Bruce H Lieske, DC 100 Main Street South, Lonsdale, MN 55046-0162 Ph: (507) 744-5514 |
Twin Cities Spine & Injury Rehabilitation, Pllc Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 708 11th Ave Ne, Lonsdale, MN 55046 Phone: 952-200-1799 Fax: 952-516-5240 | |
Lonsdale Chiropractic Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 100 Main St So, Lonsdale, MN 55046 Phone: 507-744-5514 Fax: 507-744-5513 | |
William Raymond Lieske, D.C. Chiropractor Medicare: May Accept Medicare Assignments Practice Location: 100 Main Street South, Lonsdale, MN 55046 Phone: 507-744-5514 |