| Doctor Name: | DR. WALTER CLIFFORD LEIBOLD |
| NPI Number: | 1316023526 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 4301041417 |
| Business Practice Address: | 2106 S Gray Rd West Branch, MI - 486619606 |
| Business Phone Number: | 9893457880 |
| Business Fax Number: | 9893457882 |
| Mailing Address: | 2106 S Gray Rd, WEST BRANCH |
| State: | MI |
| Postal Code: | 486619606 |
| Phone Number: | 9893457880 |
| Fax Number: | 9893457882 |
| NPI Enumeration Date: | 10/31/2006 |
| NPI Last Update Date: | 06/19/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 4301041417 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |