Provider Demographics
NPI:1942793898
Name:KUBAN, ANGELA KAREN (LMT)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:KAREN
Last Name:KUBAN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9200 W CROSS DR STE 504
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-0761
Mailing Address - Country:US
Mailing Address - Phone:303-513-7476
Mailing Address - Fax:
Practice Address - Street 1:9200 W CROSS DR STE 504
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-0761
Practice Address - Country:US
Practice Address - Phone:303-513-7476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-14
Last Update Date:2018-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT.0018157225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist