Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | OC008456 | PA |
NPI | 1073635983 |
---|---|
Provider Name | Aaron M Kubistek |
First Address | Mcmurray, PA 15317-5412 |
Second Address | Mcmurray, PA 15317-5412 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2007 |
Last Update Date | 08/07/2007 |