Individual
RICHARD LIEDL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3746 50TH AVE, ELK MOUND, WI 54739-4116
(715) 874-4935
Mailing address
3746 50TH AVE, ELK MOUND, WI 54739-4116
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
12/11/2013
Last updated
12/11/2013
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