Basic Information
| Provider Information | |||||||||
| NPI: | 1851503007 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ZUBA | ||||||||
| FirstName: | PATTRICIA | ||||||||
| MiddleName: | MARY | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | O.T.R. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10234 N. PLATT RD. | ||||||||
| Address2: | |||||||||
| City: | MILAN | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481609562 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7344397356 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1500 E. MEDICAL CENTER DRIVE 1G225 | ||||||||
| Address2: | |||||||||
| City: | ANN ARBOR | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481090046 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7349367070 | ||||||||
| FaxNumber: | 7349367016 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/03/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 5201001159 | MI | Y | Other Service Providers | Specialist |
No ID Information.