Provider Demographics
NPI:1336239516
Name:HRIBAR, MICHAEL ROBERT (MICHAEL HRIBAR)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:ROBERT
Last Name:HRIBAR
Suffix:
Gender:M
Credentials:MICHAEL HRIBAR
Other - Prefix:MR
Other - First Name:MICHAEL
Other - Middle Name:ROBERT
Other - Last Name:HRIBAR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1018 WEST MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37087
Mailing Address - Country:US
Mailing Address - Phone:216-990-1904
Mailing Address - Fax:
Practice Address - Street 1:34351 CHARDON RD.
Practice Address - Street 2:STE. E
Practice Address - City:WILLOUGHBY HILLS
Practice Address - State:OH
Practice Address - Zip Code:44094
Practice Address - Country:US
Practice Address - Phone:216-990-1904
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH7579225100000X
TN9103225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist