Individual
MA IRISA HIBANADA KUBALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
7823 OLD STATE ROAD 60, SELLERSBURG, IN 47172-1858
(812) 246-4272
(812) 246-8136
Mailing address
4903 CREEKPOINTE TERRACE, APT 7, LOUISVILLE, KY 40219-5908
(502) 968-7867
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05003464A
IN
Other
Enumeration date
07/11/2008
Last updated
07/11/2008
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