| 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 |