Provider Demographics
NPI:1194962621
Name:ULIBARRI, ISAIAH (DC)
Entity type:Individual
Prefix:DR
First Name:ISAIAH
Middle Name:
Last Name:ULIBARRI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1951 W 4700 S
Mailing Address - Street 2:SUITE 2
Mailing Address - City:TAYLORSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84118-1108
Mailing Address - Country:US
Mailing Address - Phone:801-969-4700
Mailing Address - Fax:801-969-7217
Practice Address - Street 1:6231 RIVER BLUFFS RD
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84123-6941
Practice Address - Country:US
Practice Address - Phone:801-262-3186
Practice Address - Fax:801-969-7217
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-21
Last Update Date:2009-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7227344-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor