Provider Demographics
NPI:1275005431
Name:RUBECK, JOYCE LYNN (PTA)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:LYNN
Last Name:RUBECK
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15900 ROUTE 6
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:PA
Mailing Address - Zip Code:16947-9308
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15900 ROUTE 6
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:PA
Practice Address - Zip Code:16947-9308
Practice Address - Country:US
Practice Address - Phone:570-297-4111
Practice Address - Fax:570-297-0421
Is Sole Proprietor?:No
Enumeration Date:2018-12-27
Last Update Date:2018-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225200000X
PATE1005371225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant