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NPI 1700616802

NPI 1700616802 : MELISSA SCHUBERG DPT : GREEN VALLEY, AZ

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General NPI Number Information
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    NPI Number           |    1700616802
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    Entity Type          |    Individual 
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    Provider Name        |    MELISSA SCHUBERG DPT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/05/2024
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    Last Update Date     |    12/19/2024
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Provider Practice Location Address
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    Address Line         |    18773 S NOGALES HWY STE 105 
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    City                 |    GREEN VALLEY
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    State                |    AZ
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    Zip                  |    85614-0403
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    Country              |    US
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    Telephone            |    520-477-3130
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    Fax                  |    480-885-1788
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Provider Business Mailing Address
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    Address Line         |    2001 BUTTERFIELD RD STE 1600 
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    City                 |    DOWNERS GROVE
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    State                |    IL
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    Zip                  |    60515-1211
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    LPT-033625
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    License Number State |    AZ
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