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General NPI Number Information
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NPI Number | 1053356469
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Entity Type | Organization
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Legal Business Name | LEBER CHIROPRACTIC CENTER PC
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Dates
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Enumeration Date | 06/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 521 STUMP ROAD SUITE B
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City | NORTH WALES
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State | PA
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Zip | 19454
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Country | US
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Telephone | 215-393-9909
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Fax | 215-393-9946
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Provider Business Mailing Address
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Address Line | PO BOX 97
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City | MONTGOMERYVILLE
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State | PA
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Zip | 18936
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Country | US
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Telephone | 215-393-9909
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Fax | 215-393-9946
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JEFFREY DAVID LEBER
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Credential | DC
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Telephone | 215-393-9909
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | AJ007635L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC007635L
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License Number State | PA
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