Individual
MR. ADAM LEIBOLD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
909 WALNUT ST FL 3, PHILADELPHIA, PA 19107-5211
(215) 955-7000
Mailing address
909 WALNUT ST FL 3, PHILADELPHIA, PA 19107-5211
(215) 955-1085
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/11/2019
Last updated
04/11/2019
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