MEDICARE: DMYTRO KUBRAK

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
1	111N00000X	Chiropractor	009431	AZ

General Provider Information

NPI Number	:	1891622999
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DMYTRO KUBRAK

Provider Business Mailing Address
First Line	:	1211 N FORGEUS AVE
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85716-3831
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3020 N COUNTRY CLUB RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85716-1603
Country	:	US
Telephone Number	:	520-322-6161
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2026
Last Update Date	:	05/05/2026

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Directions to “ DMYTRO KUBRAK ” Practice Location

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