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General NPI Number Information
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NPI Number | 1841071065
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Entity Type | Individual
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Provider Name | JANE UBBEN MSPT
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Gender | Female
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Dates
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Enumeration Date | 10/12/2023
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Last Update Date | 10/12/2023
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Provider Practice Location Address
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Address Line | 900 S BEACON BLVD
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City | GRAND HAVEN
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State | MI
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Zip | 49417-2146
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Country | US
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Telephone | 616-296-7300
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Fax |
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Provider Business Mailing Address
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Address Line | 1040 CADILLAC DR
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City | MUSKEGON
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State | MI
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Zip | 49445-1915
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Country | US
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Telephone | 616-914-2719
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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 | 5501006562
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License Number State | MI
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