Individual
MRS. LYNN GAEBE KUBOUSEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2400 47TH AVE S, GRAND FORKS, ND 58201-3405
(701) 746-2230
(701) 746-2475
Mailing address
115 WESTWOOD DR, GRAFTON, ND 58237-2503
(701) 352-3091
(701) 352-1270
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
200
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
58770
—
ND
Enumeration date
04/04/2007
Last updated
07/09/2007
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