Provider Demographics
NPI:1730369133
Name:LIBERMAN, DAVID REED
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:REED
Last Name:LIBERMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:DAVID
Other - Middle Name:
Other - Last Name:LIBERMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:9362 GRAND CORDERA PKWY STE 120
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80924-7007
Mailing Address - Country:US
Mailing Address - Phone:719-593-0300
Mailing Address - Fax:719-593-1451
Practice Address - Street 1:9362 GRAND CORDERA PKWY STE 120
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80924-7007
Practice Address - Country:US
Practice Address - Phone:719-593-0300
Practice Address - Fax:719-593-1451
Is Sole Proprietor?:No
Enumeration Date:2007-11-14
Last Update Date:2019-09-18
Deactivation Date:2019-09-11
Deactivation Code:
Reactivation Date:2019-09-18
Provider Licenses
StateLicense IDTaxonomies
COCHR.0005333111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor