Organization
DR JESSE LIEBMAN CHIROPRACTIC PHYSICIAN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JESSE R. LIEBMAN D.C. (PHYSICIAN)
(856) 596-3000
Entity
Organization
Contact information
Practice address
100 OLD MARLTON PIKE W, MARLTON, NJ 08053-2026
(856) 596-3000
(856) 596-7311
Mailing address
100 OLD MARLTON PIKE W, MARLTON, NJ 08053-2026
(856) 596-3000
(856) 596-7311
Taxonomy
Speciality
Code
Description
License number
State
111NN1001X
Nutrition Chiropractor
Primary
38MC00423400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2116578000
AMERIHEALTH
NJ
01
—
2664713
AETNA
NJ
01
—
P2705755
OXFORD
NJ
05
—
U35059
—
NJ
Enumeration date
05/09/2007
Last updated
04/09/2009
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