Provider Demographics
NPI:1346208816
Name:LEBER, JEFFREY DAVID (DC)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:DAVID
Last Name:LEBER
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:PO BOX 97
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERYVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18936
Mailing Address - Country:US
Mailing Address - Phone:215-393-9909
Mailing Address - Fax:215-393-9946
Practice Address - Street 1:521 STUMP RD
Practice Address - Street 2:STE B
Practice Address - City:NORTH WALES
Practice Address - State:PA
Practice Address - Zip Code:19454
Practice Address - Country:US
Practice Address - Phone:215-393-9909
Practice Address - Fax:215-393-9946
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007635L111N00000X
PAAJ007635L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
2060659000OtherIBC KEYSTONE PERSONAL CHO
039547QNGOtherHGS ADMINISTRATORS
7730225OtherAETNA PPO
N68697OtherAMERIHEALTH GROUP
P2671777OtherOXFORD HEALTH
1368697OtherHIGHMARK BLUE SHIELD GROU
2538918OtherAETNA HMO
0464475000OtherIBC KEYSTONE PERSONAL CHO
058394OtherHGS ADMINISTRATORS GROUP
646452OtherHIGHMARK BLUE SHIELD
N68697OtherAMERIHEALTH GROUP
0464475000OtherIBC KEYSTONE PERSONAL CHO
646452OtherHIGHMARK BLUE SHIELD