Provider Demographics
NPI:1780727396
Name:RUBCICH, MICHAEL ANTHONY (DC, CA)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ANTHONY
Last Name:RUBCICH
Suffix:
Gender:M
Credentials:DC, CA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 N CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-2426
Mailing Address - Country:US
Mailing Address - Phone:856-287-3127
Mailing Address - Fax:856-228-4322
Practice Address - Street 1:202A KINGS WAY W
Practice Address - Street 2:
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-2200
Practice Address - Country:US
Practice Address - Phone:856-228-1330
Practice Address - Fax:856-228-4322
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00041700171100000X
NJ38MC00597500111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist