Individual
JUSTIN J LIBERTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, LAT, ATC, CES
Contact information
Practice address
501 E 38TH ST, ERIE, PA 16546
(716) 848-9503
Mailing address
4227 ALPENHORN DR NW # APRT2, COMSTOCK PARK, MI 49321-8628
(716) 848-9503
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT006351
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BOC294305
BOARD OF CERTIFICATION
PA
Enumeration date
08/09/2016
Last updated
07/08/2018
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