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General NPI Number Information
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NPI Number | 1841739687
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Entity Type | Individual
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Provider Name | NATALEE CLAIRE TUBAUGH PTA
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Gender | Female
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Dates
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Enumeration Date | 02/13/2017
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Last Update Date | 02/13/2017
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Provider Practice Location Address
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Address Line | 1014 S MOUNT CARMEL PL
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City | PITTSBURG
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State | KS
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Zip | 66762-6604
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Country | US
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Telephone | 620-235-1500
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Fax |
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Provider Business Mailing Address
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Address Line | 604 HERITAGE LN APT B
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City | PITTSBURG
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State | KS
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Zip | 66762-7582
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Country | US
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Telephone | 417-540-9282
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 14-03092
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License Number State | KS
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