Individual
STEPHANIE RUBAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
98 EAGLE RIDGE RD, LAKE ORION, MI 48360-2612
(816) 882-0780
Mailing address
98 EAGLE RIDGE RD, LAKE ORION, MI 48360-2612
(816) 882-0780
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
7031146343
MI
Other
Enumeration date
02/04/2015
Last updated
02/04/2015
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