Provider Demographics
NPI:1134449648
Name:KUEBLER, JOY COKER (PT)
Entity type:Individual
Prefix:
First Name:JOY
Middle Name:COKER
Last Name:KUEBLER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 HIGHLAND MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39211-5949
Mailing Address - Country:US
Mailing Address - Phone:601-927-3639
Mailing Address - Fax:
Practice Address - Street 1:24 HIGHLAND MEADOWS DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39211-5949
Practice Address - Country:US
Practice Address - Phone:601-927-3639
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-07
Last Update Date:2010-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSPT0191225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist