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NPI Code Detail

MEDICARE: MISHELLE BUGTAI CUBCUBAN

MEDICARE: MISHELLE BUGTAI CUBCUBAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist003929WV

General Provider Information

NPI Number : 1447972559
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISHELLE BUGTAI CUBCUBAN
Provider Business Mailing Address
First Line : 20 BEAR OAK LN UNIT 1
Second Line :
City : CHARLESTON
State : WV
Zip : 25306-6390
Country : US
Telephone Number : 304-601-8050
Fax Number :
Provider Business Practice Location Address
First Line : 298 TRICORN RD
Second Line :
City : DANVILLE
State : WV
Zip : 25053-7148
Country : US
Telephone Number : 304-369-1385
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2022
Last Update Date : 09/15/2022

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Directions to “ MISHELLE BUGTAI CUBCUBAN ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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