Provider Demographics
NPI:1841457330
Name:LUBECKYJ, ANN S (MS RD)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:S
Last Name:LUBECKYJ
Suffix:
Gender:F
Credentials:MS RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 188
Mailing Address - Street 2:
Mailing Address - City:ALMA
Mailing Address - State:MI
Mailing Address - Zip Code:48801-0188
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6757 MAIN STREET
Practice Address - Street 2:THUMB AREA DIALYSIS
Practice Address - City:CASS CITY
Practice Address - State:MI
Practice Address - Zip Code:48726
Practice Address - Country:US
Practice Address - Phone:989-872-5544
Practice Address - Fax:989-872-5692
Is Sole Proprietor?:No
Enumeration Date:2008-05-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal