Individual
BRYCE LIEDTKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3200 ADELINE ST, BERKELEY, CA 94703-2407
(510) 506-0203
Mailing address
3200 ADELINE ST, BERKELEY, CA 94703-2407
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
07/10/2017
Last updated
07/10/2017
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