Provider Demographics
NPI:1609087378
Name:STUBLER, JOHN J (COTA)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:J
Last Name:STUBLER
Suffix:
Gender:M
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:368 LAMONT PL
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15232-2006
Mailing Address - Country:US
Mailing Address - Phone:412-362-6940
Mailing Address - Fax:940-322-4152
Practice Address - Street 1:1101 GRACE ST
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76301-4414
Practice Address - Country:US
Practice Address - Phone:940-322-3393
Practice Address - Fax:940-763-1760
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX209585224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant