Individual
KIMBERLY LIEBOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
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
0560000167
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0300788Y0VT01
BC/BS NH
NH
01
—
28994
BC/BS VT
VT
01
—
81421
MVP
VT
05
—
OVN1397
—
VT
Enumeration date
10/26/2005
Last updated
05/09/2011
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