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General NPI Number Information
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NPI Number | 1578293684
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Entity Type | Organization
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Legal Business Name | LIBERTY CENTER FAMILY MEDICINE
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Dates
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Enumeration Date | 06/13/2022
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Last Update Date | 06/13/2022
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Provider Practice Location Address
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Address Line | 100 S MAIN ST STE 2
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City | NORTH LIBERTY
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State | IN
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Zip | 46554-7705
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Country | US
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Telephone | 574-656-3919
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Fax | 574-656-3107
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Provider Business Mailing Address
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Address Line | PO BOX 315
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City | NORTH LIBERTY
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State | IN
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Zip | 46554-0315
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Country | US
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Telephone | 574-656-3919
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Fax | 574-656-3107
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Authorized Official
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Title or Position | OWNER/EMPLOYEE
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Name | SARA MARIE SINGLETON
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Credential | FNP
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Telephone | 157-430-9628
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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