Provider Demographics
NPI:1194143628
Name:LYBARGER, BRANDEN
Entity type:Individual
Prefix:
First Name:BRANDEN
Middle Name:
Last Name:LYBARGER
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 1:10730 ROSALIE DR
Mailing Address - Street 2:
Mailing Address - City:NORTHGLENN
Mailing Address - State:CO
Mailing Address - Zip Code:80233-3552
Mailing Address - Country:US
Mailing Address - Phone:720-587-7061
Mailing Address - Fax:
Practice Address - Street 1:10730 ROSALIE DR
Practice Address - Street 2:
Practice Address - City:NORTHGLENN
Practice Address - State:CO
Practice Address - Zip Code:80233-3552
Practice Address - Country:US
Practice Address - Phone:720-587-7061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-02
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other