Provider Demographics
NPI:1306435128
Name:TIBBITTS, BRETT (PHARMD)
Entity type:Individual
Prefix:DR
First Name:BRETT
Middle Name:
Last Name:TIBBITTS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2940 N CHURCH ST STE 201
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84040-6616
Mailing Address - Country:US
Mailing Address - Phone:801-771-0363
Mailing Address - Fax:801-771-0506
Practice Address - Street 1:2940 N CHURCH ST STE 201
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84040-6616
Practice Address - Country:US
Practice Address - Phone:801-771-0363
Practice Address - Fax:801-771-0506
Is Sole Proprietor?:No
Enumeration Date:2021-01-15
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT380376-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist