Provider Demographics
NPI:1396906814
Name:LALIBERTE, PAUL C (PT)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:C
Last Name:LALIBERTE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:669 GLENN VIEW CT
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:CA
Mailing Address - Zip Code:93221-1468
Mailing Address - Country:US
Mailing Address - Phone:559-592-2960
Mailing Address - Fax:559-592-9247
Practice Address - Street 1:669 GLENN VIEW CT
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:CA
Practice Address - Zip Code:93221-1468
Practice Address - Country:US
Practice Address - Phone:559-592-2960
Practice Address - Fax:559-592-9247
Is Sole Proprietor?:No
Enumeration Date:2008-06-17
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26613225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist