Individual
MR. RONALD C. KUEBLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CCC-SLP, ABDA
Contact information
Practice address
6601 EASTBROOK RD, COLUMBIA, SC 29206-2207
(803) 429-6730
(803) 787-6889
Mailing address
6601 EASTBROOK RD, COLUMBIA, SC 29206-2207
(803) 429-6730
(803) 787-6889
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
1669
GA
235Z00000X
Speech-Language Pathologist
6816
NC
235Z00000X
Speech-Language Pathologist
Primary
816
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1629000435
MEDICARE PART B
SC
01
—
203658505
TRICARE PROVIDER
SC
05
—
GP4290
—
SC
Enumeration date
07/06/2006
Last updated
04/26/2013
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