Individual
GEROD UNDRON HUBBARD JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAC, ATC
Contact information
Practice address
425 W UNIVERSITY BLVD, DURANT, OK 74701-3347
(580) 745-3214
Mailing address
4791 COUNTY ROAD 2105, HOOKS, TX 75561-7562
(903) 278-5594
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
965
OK
Other
Enumeration date
12/08/2017
Last updated
12/08/2017
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