Provider Demographics
NPI:1144787037
Name:CUBBAGE, AARON (LMT)
Entity Type:Individual
Prefix:MR
First Name:AARON
Middle Name:
Last Name:CUBBAGE
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 MOUNTAIN VIEW DRIVE
Mailing Address - Street 2:
Mailing Address - City:PETERBOROUGH
Mailing Address - State:NH
Mailing Address - Zip Code:03458
Mailing Address - Country:US
Mailing Address - Phone:804-803-1462
Mailing Address - Fax:
Practice Address - Street 1:20 DEPOT STREET
Practice Address - Street 2:SUITE 310-3
Practice Address - City:PETERBOROUGH
Practice Address - State:NH
Practice Address - Zip Code:03458
Practice Address - Country:US
Practice Address - Phone:804-803-1462
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-27
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH5059MT225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist