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NPI Code Detail

MEDICARE: LINDA KUBALL OTR

MEDICARE: LINDA KUBALL OTR
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
1225XG0600XGerontology Occupational Therapist5201004173MI

General Provider Information

NPI Number : 1902383037
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINDA KUBALL OTR
Provider Business Mailing Address
First Line : 11098 LANDON RD
Second Line :
City : BARODA
State : MI
Zip : 49101-8902
Country : US
Telephone Number : 269-921-1088
Fax Number :
Provider Business Practice Location Address
First Line : 9935 RED ARROW HWY
Second Line :
City : BRIDGMAN
State : MI
Zip : 49106-9002
Country : US
Telephone Number : 269-465-3017
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2018
Last Update Date : 07/21/2018

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Directions to “ LINDA KUBALL OTR” Practice Location

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