Provider Demographics
NPI:1912915455
Name:LUBBERS, JEFFREY ALAN (PT)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:ALAN
Last Name:LUBBERS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3116 COMSTOCK RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-3507
Mailing Address - Country:US
Mailing Address - Phone:919-872-6167
Mailing Address - Fax:919-872-6167
Practice Address - Street 1:1001 PEMBERTON HILL RD
Practice Address - Street 2:SUITE 202
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502-4265
Practice Address - Country:US
Practice Address - Phone:010-367-0866
Practice Address - Fax:919-367-0866
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC1119225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist