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NPI Code Detail

MEDICARE: DAVID LIBERT PT

MEDICARE:   DAVID  LIBERT  PT
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
1225100000XPhysical Therapist25571FL
2225100000XPhysical TherapistP13212NC

General Provider Information

NPI Number : 1073824298
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID LIBERT PT
Provider Business Mailing Address
First Line : 104 HOLCOMBE COVE RD
Second Line :
City : CANDLER
State : NC
Zip : 28715-9452
Country : US
Telephone Number : 828-667-9851
Fax Number :
Provider Business Practice Location Address
First Line : 104 HOLCOMBE COVE RD
Second Line :
City : CANDLER
State : NC
Zip : 28715-9452
Country : US
Telephone Number : 828-667-9851
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2010
Last Update Date : 05/12/2016

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Directions to “ DAVID LIBERT PT” Practice Location

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