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Individual

BRENT LEIBY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ATC

Contact information

Practice address
108 OMEGA CIR, WERNERSVILLE, PA 19565-1643
(610) 678-1434
Mailing address
108 OMEGA CIR, WERNERSVILLE, PA 19565-1643
(610) 678-1434

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
RT001543A
PA

Other

Enumeration date
07/17/2006
Last updated
07/09/2007
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