Provider Demographics
NPI:1619285707
Name:ULIBARRI, VINCENT HUNT
Entity Type:Individual
Prefix:
First Name:VINCENT
Middle Name:HUNT
Last Name:ULIBARRI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 WYOMING ST
Mailing Address - Street 2:
Mailing Address - City:BOULDER CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89005-2822
Mailing Address - Country:US
Mailing Address - Phone:702-927-9271
Mailing Address - Fax:702-294-4362
Practice Address - Street 1:303 WYOMING ST
Practice Address - Street 2:
Practice Address - City:BOULDER CITY
Practice Address - State:NV
Practice Address - Zip Code:89005-2822
Practice Address - Country:US
Practice Address - Phone:702-927-9271
Practice Address - Fax:702-294-4362
Is Sole Proprietor?:No
Enumeration Date:2010-09-22
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner