Individual
LIBERTY BELLE JAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
825 OLD LANCASTER RD, BRYN MAWR, PA 19010-3231
(610) 922-2100
(610) 520-2091
Mailing address
27 S BRYN MAWR AVE, BRYN MAWR, PA 19010-3406
(610) 527-2727
(610) 527-1588
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA051793
PA
Other
Enumeration date
06/21/2006
Last updated
03/19/2019
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