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NPI Code Detail

MEDICARE: JULIA LIBBY DPT

MEDICARE: JULIA LIBBY DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist8321505-8016UT

General Provider Information

NPI Number : 1134484454
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIA LIBBY DPT
Provider Business Mailing Address
First Line : PO BOX 307
Second Line :
City : BOUNTIFUL
State : UT
Zip : 84011-0307
Country : US
Telephone Number : 801-294-6907
Fax Number : 801-294-6917
Provider Business Practice Location Address
First Line : 5151 S 900 E STE 100
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84117-6658
Country : US
Telephone Number : 801-261-3321
Fax Number : 801-261-5942
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2012
Last Update Date : 10/28/2020

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