Provider Demographics
NPI:1659793974
Name:CRIBELLI, BRETT ADDISON (PT)
Entity Type:Individual
Prefix:MR
First Name:BRETT
Middle Name:ADDISON
Last Name:CRIBELLI
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 NEBR AVE
Mailing Address - Street 2:
Mailing Address - City:ARAPAHOE
Mailing Address - State:NE
Mailing Address - Zip Code:68922-0617
Mailing Address - Country:US
Mailing Address - Phone:308-962-8435
Mailing Address - Fax:308-962-8436
Practice Address - Street 1:211 NEBRASKA AVE
Practice Address - Street 2:
Practice Address - City:ARAPAHOE
Practice Address - State:NE
Practice Address - Zip Code:68922-0617
Practice Address - Country:US
Practice Address - Phone:308-962-8435
Practice Address - Fax:308-962-8436
Is Sole Proprietor?:No
Enumeration Date:2014-01-07
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3211225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist