Basic Information
| Provider Information | |||||||||
| NPI: | 1225452170 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DUBAY | ||||||||
| FirstName: | THOMAS | ||||||||
| MiddleName: | VINCENT | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PT, DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4351 24TH AVE STE 1 | ||||||||
| Address2: | |||||||||
| City: | FORT GRATIOT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480594506 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8103857405 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3105 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | MARLETTE | ||||||||
| State: | MI | ||||||||
| PostalCode: | 484531508 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9896353660 | ||||||||
| FaxNumber: | 9896353662 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/13/2014 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2251X0800X | 5501016649 | MI | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic |
No ID Information.