| Liberty Healthcare Llc | |
|
5589 Greenwich Rd Suite 175 Virginia Beach VA 23462-6565 | |
| (757) 216-9115 | |
| (757) 216-9117 |
| Full Name | Liberty Healthcare Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 5589 Greenwich Rd, Virginia Beach, Virginia |
| Authorized Official Name and Position | Derk Pardoe (PARTNER) |
| Authorized Official Contact | 8018082357 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Liberty Healthcare Llc 3454 E Stone Mountain Ln Sandy UT 84092-6549 Ph: (801) 808-2357 | Liberty Healthcare Llc 5589 Greenwich Rd Suite 175 Virginia Beach VA 23462-6565 Ph: (757) 216-9115 |
| NPI Number | 1720332349 |
|---|---|
| Provider Enumeration Date | 11/05/2012 |
| Last Update Date | 11/05/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720332349 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 140177 (Virginia) | Primary |
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