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NPI Code Detail

MEDICARE: DR. JAMES A LIEBELT D.C.

MEDICARE:  DR. JAMES A LIEBELT  D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor278338-1202UT

General Provider Information

NPI Number : 1821042102
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAMES A LIEBELT D.C.
Provider Business Mailing Address
First Line : PO BOX 3
Second Line :
City : BRIGHAM CITY
State : UT
Zip : 84302-0003
Country : US
Telephone Number : 435-723-6033
Fax Number :
Provider Business Practice Location Address
First Line : 60 S MAIN ST
Second Line : SUITE 104
City : BRIGHAM CITY
State : UT
Zip : 84302-6719
Country : US
Telephone Number : 435-723-6033
Fax Number : 435-723-1635
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2006
Last Update Date : 05/01/2014

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Directions to “ DR. JAMES A LIEBELT D.C.” Practice Location

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