Provider Demographics
NPI:1699014654
Name:LIEBMAN WELLNESS CENTER, P.C.
Entity Type:Organization
Organization Name:LIEBMAN WELLNESS CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER COLLCTIONS
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:R
Authorized Official - Last Name:NORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-827-3544
Mailing Address - Street 1:100 OLD MARLTON PIKE W
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-2026
Mailing Address - Country:US
Mailing Address - Phone:973-827-3544
Mailing Address - Fax:973-827-3588
Practice Address - Street 1:100 OLD MARLTON PIKE W
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-2026
Practice Address - Country:US
Practice Address - Phone:973-827-3544
Practice Address - Fax:973-827-3588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-11
Last Update Date:2013-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC04234111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty