Healthcare Provider Details

I. General information

NPI: 1760346225
Provider Name (Legal Business Name): JACOB CALVIN HUBBARD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: CAL HUBBARD PT, DPT

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/10/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1030 COPPERFIELD BLVD SUITE 107
CONCORD NC
28025
US

IV. Provider business mailing address

1429 BRYANT ST STE A
CHARLOTTE NC
28208-5201
US

V. Phone/Fax

Practice location:
  • Phone: 980-777-8031
  • Fax: 980-777-8008
Mailing address:
  • Phone: 704-919-0867
  • Fax: 704-817-8579

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: