Sean Leibrock
Student in an Organized Health Care Education/Training Program in Morgantown, WV. Individual provider (NPI-1).
NPI number1730438797
StatusActive
Last updated in NPPESMar 27, 2025
Details
- NPI
- 1730438797
- Entity type
- Individual (NPI-1)
- Name
- Sean Leibrock
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 6, 2012
- Certification date
- Mar 27, 2025
- Last updated
- Mar 27, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
| 1710I1002X | Military Health Care Provider, Independent Duty Corpsman | – | – |
Practice location
101 Stadium DrMorgantown, WV 26506-7911
Phone 304-598-4850 · Fax 304-598-4871
Mailing address
101 Stadium DrMorgantown, WV 26506-7911
Phone 304-598-4850
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