Provider Demographics
NPI:1659586139
Name:KUBOTA, NAOKI (LAC)
Entity Type:Individual
Prefix:MR
First Name:NAOKI
Middle Name:
Last Name:KUBOTA
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 ORANGE ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-2340
Mailing Address - Country:US
Mailing Address - Phone:828-713-4755
Mailing Address - Fax:
Practice Address - Street 1:47 ORANGE ST
Practice Address - Street 2:SUITE A
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-2340
Practice Address - Country:US
Practice Address - Phone:828-713-4755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2017-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC024171100000X
SC264171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist