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General NPI Number Information
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NPI Number | 1699989947
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Entity Type | Organization
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Legal Business Name | DR JESSE LIEBMAN CHIROPRACTIC PHYSICIAN LLC
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 04/09/2009
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Provider Practice Location Address
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Address Line | 100 OLD MARLTON PIKE W
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City | MARLTON
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State | NJ
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Zip | 08053-2026
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Country | US
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Telephone | 856-596-3000
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Fax | 856-596-7311
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Provider Business Mailing Address
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Address Line | 100 OLD MARLTON PIKE W
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City | MARLTON
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State | NJ
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Zip | 08053-2026
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Country | US
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Telephone | 856-596-3000
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Fax | 856-596-7311
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. JESSE R. LIEBMAN
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Credential | D.C.
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Telephone | 856-596-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NN1001X
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Taxonomy Name | Nutrition Chiropractor
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License Number | 38MC00423400
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License Number State | NJ
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