Provider Demographics
NPI:1255749701
Name:RUBINIC, DYLAN MICHAEL (PT, DPT, ATC)
Entity type:Individual
Prefix:DR
First Name:DYLAN
Middle Name:MICHAEL
Last Name:RUBINIC
Suffix:
Gender:M
Credentials:PT, DPT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1783 MORNINGTIDE CT
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99501-5722
Mailing Address - Country:US
Mailing Address - Phone:828-446-7381
Mailing Address - Fax:
Practice Address - Street 1:13015 OLD GLENN HWY
Practice Address - Street 2:
Practice Address - City:EAGLE RIVER
Practice Address - State:AK
Practice Address - Zip Code:99577-7567
Practice Address - Country:US
Practice Address - Phone:907-562-2277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-29
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305211951225100000X
AK134958225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA2305211951OtherVIRGINIA PHYSICAL THERAPY LICENSE BOARD