Provider Demographics
NPI:1215951918
Name:LIEBER, MATTHEW J (DC)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:J
Last Name:LIEBER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:677 TOMLINSON LN
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-6329
Mailing Address - Country:US
Mailing Address - Phone:267-392-5512
Mailing Address - Fax:267-392-5512
Practice Address - Street 1:81 BIG OAK RD
Practice Address - Street 2:124
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-7801
Practice Address - Country:US
Practice Address - Phone:215-971-2720
Practice Address - Fax:215-253-5333
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-006195-L111N00000X
PAAJ-006195-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU58481Medicare UPIN
PA842755Medicare ID - Type Unspecified