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Individual

DAVID LIEBOW

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
382 CANAL ST, BRATTLEBORO, VT 05301-6617
(802) 254-0202
(802) 246-1300
Mailing address
PO BOX 910, GREENFIELD, MA 01302-0910
(413) 772-8500
(413) 772-8900

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
0560000157
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
19943
BC/BS VT
VT
05
30007741
NH
01
78569
MVP
VT
05
OVN0942
VT
Enumeration date
10/26/2005
Last updated
05/09/2011
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