Provider Information for 1073231817
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ALICEA LYBARGER
Sex: Female
NPI: 1073231817
Last Updated: 2022-08-18
Certification Date: 2022-08-16
Certification Date: 2022-08-16
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1073231817 | ||||||||
| Enumeration Date | 2022-08-18 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 16143 HI LAND CIR BRIGHTON, CO 80602-7515 United States Phone: 720-427-4625 | Fax: | ||||||||
| Primary Practice Address | 80 GARDEN CTR STE 170 BROOMFIELD, CO 80020-1790 United States Phone: 720-740-2466 | Fax: | ||||||||
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