| NPI | 1740383751 |
|---|---|
| Other Name | SMOKEY KUBACAK |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1016228) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX PT1016228) |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2023-10-02 |