Provider Demographics
NPI:1891863098
Name:CUBA, MICHAEL J (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:CUBA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:300 N CEDAR ST STE 103
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:KS
Mailing Address - Zip Code:67410-2623
Mailing Address - Country:US
Mailing Address - Phone:785-263-3200
Mailing Address - Fax:785-263-3200
Practice Address - Street 1:300 N CEDAR ST STE 103
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:KS
Practice Address - Zip Code:67410-2623
Practice Address - Country:US
Practice Address - Phone:785-263-3200
Practice Address - Fax:785-263-3200
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0104214111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS023884Medicare PIN