Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 01495 | MD |
N | 111NR0400X | Rehabilitation Chiropractor | 01495 | MD |
NPI | 1255417986 |
---|---|
Provider Name | Richard M Liberati |
First Address | Baltimore, MD 21270-0160 |
Second Address | Baltimore, MD 21215-2686 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2006 |
Last Update Date | 08/07/2007 |