Provider Demographics
NPI:1336319987
Name:DEBORAH C LEIBLE DC PC
Entity Type:Organization
Organization Name:DEBORAH C LEIBLE DC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:C
Authorized Official - Last Name:LEIBLE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:808-822-7955
Mailing Address - Street 1:5282A KAWAIHAU RD
Mailing Address - Street 2:
Mailing Address - City:KAPAA
Mailing Address - State:HI
Mailing Address - Zip Code:96746-2103
Mailing Address - Country:US
Mailing Address - Phone:808-822-7955
Mailing Address - Fax:808-822-0009
Practice Address - Street 1:5282A KAWAIHAU RD
Practice Address - Street 2:
Practice Address - City:KAPAA
Practice Address - State:HI
Practice Address - Zip Code:96746-2103
Practice Address - Country:US
Practice Address - Phone:808-822-7955
Practice Address - Fax:808-822-0009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-10
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI101424Medicare PIN