Individual
BRIDGET LIEBERUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
133 AVIATION RD, QUEENSBURY, NY 12804-8206
(518) 798-0170
(518) 761-9538
Mailing address
133 AVIATION ROAD, QUEENSBURY, NY 12804-8206
(518) 798-0170
(518) 761-9538
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
022017
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00752456
—
NY
Enumeration date
03/12/2010
Last updated
03/12/2010
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