Individual
BRETT H LIESEMEYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
3403 W 10TH ST, SEDALIA, MO 65301-2112
(660) 826-6161
(660) 826-8197
Mailing address
3403 W 10TH ST, SEDALIA, MO 65301-2112
(660) 826-6161
(660) 826-8197
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T02629
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
312338908
—
MO
Enumeration date
11/06/2006
Last updated
06/19/2008
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