Individual
ERIC KUBATZKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
201 TURNER MCCALL BLVD NW, ROME, GA 30165-2545
(706) 236-2758
(706) 802-1408
Mailing address
PO BOX 949, ROME, GA 30162-0949
(706) 236-2758
(706) 802-1408
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT007061
GA
225100000X
Physical Therapist
Primary
PT21231
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00365041
RR MEDICARE
FL
Enumeration date
07/05/2005
Last updated
10/22/2007
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