Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 1609 | IA |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 01609 | IA |
NPI | 1124346507 |
---|---|
Provider Name | Mr. David L Rubsam |
First Address | Marion, IA 52302-3846 |
Second Address | Marion, IA 52302-3846 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2010 |
Last Update Date | 25/04/2013 |