Liedke, Larry

Liedke, Larry is an individual health care provider with primary practice located at 125 W Main St Suit B, Wauchula FL 33873-2819. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Liedke, Larry can be contacted via phone (863) 448-4332.

Contact Information

Primary practice address
125 W Main St Suit B Wauchula FL 33873-2819
Phone: (863) 448-4332
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X

Profile Details

NPI number 1043614977
LBN Legal business name Liedke, Larry
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 21st, 2014
Last updated Oct 21st, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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