Provider Demographics
NPI:1245561729
Name:TUBBS CHIROPRACTIC, P.A.
Entity type:Organization
Organization Name:TUBBS CHIROPRACTIC, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:TUBBS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:507-369-5601
Mailing Address - Street 1:226 W CLARK ST
Mailing Address - Street 2:
Mailing Address - City:ALBERT LEA
Mailing Address - State:MN
Mailing Address - Zip Code:56007-2548
Mailing Address - Country:US
Mailing Address - Phone:507-369-5601
Mailing Address - Fax:507-369-5602
Practice Address - Street 1:226 W CLARK ST
Practice Address - Street 2:
Practice Address - City:ALBERT LEA
Practice Address - State:MN
Practice Address - Zip Code:56007-2548
Practice Address - Country:US
Practice Address - Phone:507-369-5601
Practice Address - Fax:507-369-5602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-22
Last Update Date:2010-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty