Provider Demographics
NPI:1417745092
Name:CHAD D LIESER DC PA
Entity type:Organization
Organization Name:CHAD D LIESER DC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:LIESER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:941-977-2871
Mailing Address - Street 1:1946 S TAMIAMI TRL
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34293-5001
Mailing Address - Country:US
Mailing Address - Phone:941-977-2871
Mailing Address - Fax:
Practice Address - Street 1:1946 S TAMIAMI TRL
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34293-5001
Practice Address - Country:US
Practice Address - Phone:941-977-2871
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-25
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty