Provider Demographics
NPI:1265491989
Name:LIBERTY, REBEKAH SCHELL (DC)
Entity type:Individual
Prefix:DR
First Name:REBEKAH
Middle Name:SCHELL
Last Name:LIBERTY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:REBEKAH
Other - Middle Name:R
Other - Last Name:SCHELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:8356 BURNSIDE DR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116-1836
Mailing Address - Country:US
Mailing Address - Phone:803-322-3156
Mailing Address - Fax:
Practice Address - Street 1:17212 MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:MONTPELIER
Practice Address - State:VA
Practice Address - Zip Code:23192-2554
Practice Address - Country:US
Practice Address - Phone:804-883-3000
Practice Address - Fax:804-883-3060
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT6169111N00000X
SC2963111N00000X
VA0104557840111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCCH2963Medicaid
SCAA06828033Medicare ID - Type Unspecified