Provider Demographics
NPI:1265107858
Name:LIBERTY ELECTRODIAGNOSTICS PLLC
Entity type:Organization
Organization Name:LIBERTY ELECTRODIAGNOSTICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:940-782-3158
Mailing Address - Street 1:217 HONEY BROOK LN
Mailing Address - Street 2:
Mailing Address - City:ALEDO
Mailing Address - State:TX
Mailing Address - Zip Code:76008-1799
Mailing Address - Country:US
Mailing Address - Phone:940-782-3158
Mailing Address - Fax:
Practice Address - Street 1:217 HONEY BROOK LN
Practice Address - Street 2:
Practice Address - City:ALEDO
Practice Address - State:TX
Practice Address - Zip Code:76008-1799
Practice Address - Country:US
Practice Address - Phone:940-782-3158
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-16
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251E1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistElectrophysiology, ClinicalGroup - Single Specialty