Provider Demographics
NPI:1609249614
Name:RUBOW, KYLEIGH (MPT)
Entity Type:Individual
Prefix:
First Name:KYLEIGH
Middle Name:
Last Name:RUBOW
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2908 24TH ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95818-3542
Mailing Address - Country:US
Mailing Address - Phone:916-600-4949
Mailing Address - Fax:
Practice Address - Street 1:9279 STAR STREAK CIR
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80125-1891
Practice Address - Country:US
Practice Address - Phone:916-600-4949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-12
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42599208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation