Provider Demographics
NPI:1003357732
Name:KUBRICK, AMBER (PT)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:KUBRICK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:
Other - Last Name:KUBICK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:625 LINCOLN AVE
Mailing Address - Street 2:SUITE 209
Mailing Address - City:N. CHARLEROI
Mailing Address - State:PA
Mailing Address - Zip Code:15022
Mailing Address - Country:US
Mailing Address - Phone:724-483-2159
Mailing Address - Fax:724-489-0282
Practice Address - Street 1:566 PINE HOLLOW RD
Practice Address - Street 2:
Practice Address - City:MC KEES ROCKS
Practice Address - State:PA
Practice Address - Zip Code:15136-1661
Practice Address - Country:US
Practice Address - Phone:412-771-1055
Practice Address - Fax:412-771-2256
Is Sole Proprietor?:No
Enumeration Date:2017-03-14
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT025799225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist