Provider Demographics
NPI:1255441986
Name:HUBBARD, DONALD M (PT)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:M
Last Name:HUBBARD
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1346 ROUTE 739
Mailing Address - Street 2:
Mailing Address - City:DINGMANS FERRY
Mailing Address - State:PA
Mailing Address - Zip Code:18328-3423
Mailing Address - Country:US
Mailing Address - Phone:570-686-4300
Mailing Address - Fax:570-686-4302
Practice Address - Street 1:1346 ROUTE 739
Practice Address - Street 2:
Practice Address - City:DINGMANS FERRY
Practice Address - State:PA
Practice Address - Zip Code:18328-3423
Practice Address - Country:US
Practice Address - Phone:570-686-4300
Practice Address - Fax:570-686-4302
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT009575L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA107324Medicare PIN