Individual
MICHAEL R BIBBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, LAT, ATC, CES
Contact information
Practice address
2450 N 54TH ST, PHILADELPHIA, PA 19131-1309
(610) 517-9043
Mailing address
518 SPRING MILL AVE, CONSHOHOCKEN, PA 19428-1950
(610) 517-9043
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RTO000092
PA
Other
Enumeration date
12/16/2017
Last updated
12/16/2017
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