Provider Demographics
NPI:1851839245
Name:HUBBARD, RYAN THOMAS (DPT)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:THOMAS
Last Name:HUBBARD
Suffix:
Gender:M
Credentials:DPT
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Other - First Name:
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Mailing Address - Street 1:1007 HARBOR HILLS DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:MARQUETTE
Mailing Address - State:MI
Mailing Address - Zip Code:49855-8977
Mailing Address - Country:US
Mailing Address - Phone:906-225-8011
Mailing Address - Fax:906-225-8033
Practice Address - Street 1:1007 HARBOR HILLS DR
Practice Address - Street 2:SUITE B
Practice Address - City:MARQUETTE
Practice Address - State:MI
Practice Address - Zip Code:49855-8977
Practice Address - Country:US
Practice Address - Phone:906-225-8011
Practice Address - Fax:906-225-8033
Is Sole Proprietor?:No
Enumeration Date:2017-02-06
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist