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General NPI Number Information
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NPI Number | 1285792176
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Entity Type | Organization
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Legal Business Name | LIBERTY CHIROPRACTIC P.C.
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 804 E MAIN ST STE A2
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City | BEDFORD
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State | VA
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Zip | 24523-2919
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Country | US
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Telephone | 540-587-0200
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Fax | 540-587-0935
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Provider Business Mailing Address
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Address Line | 804 E MAIN ST STE A2
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City | BEDFORD
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State | VA
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Zip | 24523-2919
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Country | US
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Telephone | 540-587-0200
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Fax | 540-587-0935
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN M EARSING
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Credential | DC
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Telephone | 540-587-0200
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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 | 0104555903
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License Number State | VA
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