Provider Demographics
NPI:1376350330
Name:LIEDL, SARAH
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:LIEDL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:BRZOZOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4997 COUNTY HIGHWAY F
Mailing Address - Street 2:
Mailing Address - City:CHIPPEWA FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54729-5744
Mailing Address - Country:US
Mailing Address - Phone:715-559-9755
Mailing Address - Fax:
Practice Address - Street 1:4997 COUNTY HIGHWAY F
Practice Address - Street 2:
Practice Address - City:CHIPPEWA FALLS
Practice Address - State:WI
Practice Address - Zip Code:54729-5744
Practice Address - Country:US
Practice Address - Phone:715-559-9755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-13
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care