Provider Demographics
NPI:1164852224
Name:LIBRETT, JOHN (PHD, MPH)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:LIBRETT
Suffix:
Gender:M
Credentials:PHD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1151 E CASTLE ROCK RD
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84094-5688
Mailing Address - Country:US
Mailing Address - Phone:801-558-5950
Mailing Address - Fax:
Practice Address - Street 1:1151 E CASTLE ROCK RD
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84094-5688
Practice Address - Country:US
Practice Address - Phone:801-558-5950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-26
Last Update Date:2013-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist