Individual
DR. JESSE R. LIEBMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC.
Contact information
Practice address
100 OLD MARLTON PIKE W, MARLTON, NJ 08053-2026
(856) 596-3000
(856) 596-3301
Mailing address
100 OLD MARLTON PIKE W, MARLTON, NJ 08053-2026
(856) 596-3000
(856) 596-3301
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
01/12/2007
Last updated
09/28/2007
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