Individual
SANDRA KUBACKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
2498 DAYTON XENIA RD, BEAVERCREEK, OH 45434-7169
(937) 427-1919
(937) 427-1949
Mailing address
2498 DAYTON XENIA RD, BEAVERCREEK, OH 45434-7169
(937) 427-1919
(937) 427-1949
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
PT013205
OH
Other
Enumeration date
02/01/2012
Last updated
02/01/2012
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