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NPI Code Detail

MEDICARE: LIESKE CHIROPRACTIC PLLC

MEDICARE: LIESKE CHIROPRACTIC PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractorCH11536FL

General Provider Information

NPI Number : 1063874246
Entity Type Code : Organization
Provider Name (Legal Business Name) : LIESKE CHIROPRACTIC PLLC
Provider Business Mailing Address
First Line : 1217 WHITE ST
Second Line :
City : KEY WEST
State : FL
Zip : 33040-3367
Country : US
Telephone Number : 305-292-7222
Fax Number : 888-473-3112
Provider Business Practice Location Address
First Line : 1217 WHITE ST
Second Line :
City : KEY WEST
State : FL
Zip : 33040-3367
Country : US
Telephone Number : 305-292-7222
Fax Number : 888-473-3112
Authorized Official
Title or Position : OWNER
Name : DR. BRUCE HARLEN LIESKE
Credential : DC
Telephone Number : 305-292-7222
Provider Enumeration Date : 03/25/2016
Last Update Date : 03/25/2016

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Directions to “LIESKE CHIROPRACTIC PLLC ” Practice Location

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