Provider Demographics
NPI:1760524177
Name:LOBO, MICHELE A (PT, PHD)
Entity Type:Individual
Prefix:MS
First Name:MICHELE
Middle Name:A
Last Name:LOBO
Suffix:
Gender:F
Credentials:PT, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:337 WALLACE DR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19711-2011
Mailing Address - Country:US
Mailing Address - Phone:302-547-8233
Mailing Address - Fax:302-831-4234
Practice Address - Street 1:DELAWARE & ACADEMY AVENUES
Practice Address - Street 2:PT CLINIC, MCKINLY BUILDING, THE UNIVERSITY OF DELAWARE
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19716
Practice Address - Country:US
Practice Address - Phone:302-831-8893
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ1-0001384225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist