Organization
VITA POST ACUTE MEDICAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE KUBIK PT (CEO)
(855) 722-9700
Entity
Organization
Contact information
Practice address
1778 NE CORNELL RD, HILLSBORO, OR 97124-2740
(855) 722-9700
Mailing address
PO BOX 73488, PUYALLUP, WA 98373-0488
(855) 722-9700
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
Other
Enumeration date
02/26/2020
Last updated
11/07/2022
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