Healthcare Provider Details

I. General information

NPI: 1205832508
Provider Name (Legal Business Name): MICHAEL D BARTELS PT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2005
Last Update Date: 03/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11336 S 96TH ST SUITE 114
PAPILLION NE
68046-4209
US

IV. Provider business mailing address

11336 S 96TH ST SUITE 114
PAPILLION NE
68046-4209
US

V. Phone/Fax

Practice location:
  • Phone: 402-315-3603
  • Fax: 402-315-3604
Mailing address:
  • Phone: 402-315-3603
  • Fax: 402-315-3604

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number847
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number847
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: