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Individual
ERIC JAMES LIAZUK
Active
Individual
ERIC JAMES LIAZUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4181-012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
115599
SECURITY HEALTH PLAN
—
05
—
38965500
—
WI
01
—
38994000
MEDICAID GROUP
WI
Enumeration date
06/03/2006
Last updated
10/30/2017
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