Provider Demographics
NPI:1154495521
Name:LIEBELL, DONALD KENNETH (DC)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:KENNETH
Last Name:LIEBELL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:477 VIKING DR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-7349
Mailing Address - Country:US
Mailing Address - Phone:757-631-9799
Mailing Address - Fax:757-631-9866
Practice Address - Street 1:477 VIKING DR
Practice Address - Street 2:SUITE 203
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-7349
Practice Address - Country:US
Practice Address - Phone:757-631-9799
Practice Address - Fax:757-631-9866
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001160111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA117658OtherANTHEM BCBS