Individual
CHARLES B KUBASKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
4517 LEAD MINE RD, RALEIGH, NC 27612-3326
(919) 781-8830
(919) 781-1678
Mailing address
4517 LEAD MINE RD, RALEIGH, NC 27612-3326
(919) 781-8830
(919) 781-1678
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1346
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08596
BLUE CROSS BLUE SHIELD
NC
05
—
8908596
—
NC
Enumeration date
07/18/2006
Last updated
08/07/2009
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