Individual
MR. MICHAEL AARON YBARRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
601 GREGORY ST, NORMAL, IL 61790-0001
(956) 926-9476
Mailing address
303 TURNBERRY DR APT C, BLOOMINGTON, IL 61701-1484
(956) 926-9476
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000032650
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000032650
BOARD OF CERTIFICATION
—
Enumeration date
06/15/2018
Last updated
06/15/2018
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