Provider Demographics
NPI:1649609942
Name:PRIBNOW, TRAVIS DUANE (PT, DPT)
Entity type:Individual
Prefix:
First Name:TRAVIS
Middle Name:DUANE
Last Name:PRIBNOW
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11211 SEWARD PLZ
Mailing Address - Street 2:APT. 2603
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-4936
Mailing Address - Country:US
Mailing Address - Phone:402-380-3429
Mailing Address - Fax:
Practice Address - Street 1:10858 W DODGE RD
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-2609
Practice Address - Country:US
Practice Address - Phone:402-614-7500
Practice Address - Fax:402-614-4449
Is Sole Proprietor?:No
Enumeration Date:2013-11-06
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3298225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist