Healthcare Provider Details

I. General information

NPI: 1518471341
Provider Name (Legal Business Name): NICHOLAS MARK RIBAR DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2017
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2151 HAMLINE AVE N STE 111
SAINT PAUL MN
55113-4226
US

IV. Provider business mailing address

2151 HAMLINE AVE N STE 111
SAINT PAUL MN
55113-4226
US

V. Phone/Fax

Practice location:
  • Phone: 651-288-3098
  • Fax: 651-203-0047
Mailing address:
  • Phone: 651-288-3098
  • Fax: 651-203-0047

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number6431
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: