Individual
TEISHA M KUBALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
8325 W HAPPY VALLEY RD, UNIT 105, PEORIA, AZ 85383-4361
(602) 547-2111
(602) 547-0473
Mailing address
5605 W EUGIE AVE, SUITE 102, GLENDALE, AZ 85304-1272
(602) 547-2111
(602) 547-0473
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
0459
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
45946301
—
AZ
Enumeration date
04/26/2006
Last updated
02/04/2020
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