Organization
MALLETTS BAY CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH M LIEBMAN DC (PARTNER)
(802) 865-2255
Entity
Organization
Contact information
Practice address
500 HEINEBERG DR, COLCHESTER, VT 05446-6772
(802) 865-2255
Mailing address
PO BOX 768, COLCHESTER, VT 05446-0768
(802) 865-2255
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
808
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4427
VT BLUE CROSS
VT
Enumeration date
10/12/2006
Last updated
08/22/2020
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