Provider Demographics
NPI:1851503007
Name:ZUBA, PATTRICIA MARY (OTR)
Entity Type:Individual
Prefix:MS
First Name:PATTRICIA
Middle Name:MARY
Last Name:ZUBA
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10234 N. PLATT RD.
Mailing Address - Street 2:
Mailing Address - City:MILAN
Mailing Address - State:MI
Mailing Address - Zip Code:48160-9562
Mailing Address - Country:US
Mailing Address - Phone:734-439-7356
Mailing Address - Fax:
Practice Address - Street 1:1500 E. MEDICAL CENTER DRIVE 1G225
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-0046
Practice Address - Country:US
Practice Address - Phone:734-936-7070
Practice Address - Fax:734-936-7016
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201001159174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist