Individual
MS. CHERUBA THEODORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPT
Contact information
Practice address
6101 N STATE LINE AVE, TEXARKANA, TX 75503-5309
(903) 791-2288
Mailing address
6612 PALISADES, TEXARKANA, TX 75503-4972
(903) 781-2437
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1158790
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760274
—
TX
Enumeration date
10/23/2006
Last updated
07/08/2007
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