MEDICARE: DR. MICHELE HIPPLER DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT013190	OH

General Provider Information

NPI Number	:	1043831613
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHELE HIPPLER DPT

Provider Business Mailing Address
First Line	:	19235 RIVERVIEW AVE
Second Line	:
City	:	ROCKY RIVER
State	:	OH
Zip	:	44116-2631
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	26908 DETROIT RD STE 300
Second Line	:
City	:	WESTLAKE
State	:	OH
Zip	:	44145-2399
Country	:	US
Telephone Number	:	440-414-6050
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2020
Last Update Date	:	05/05/2020

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