Provider Demographics
NPI:1174757546
Name:TUBIO, FE S (LMT,LLCC,NTCMB,CCA)
Entity type:Individual
Prefix:MS
First Name:FE
Middle Name:S
Last Name:TUBIO
Suffix:
Gender:F
Credentials:LMT,LLCC,NTCMB,CCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11565 PERRY HWY
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-8799
Mailing Address - Country:US
Mailing Address - Phone:724-933-6130
Mailing Address - Fax:724-933-6138
Practice Address - Street 1:11565 PERRY HWY
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-8799
Practice Address - Country:US
Practice Address - Phone:724-933-6130
Practice Address - Fax:724-933-6138
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-13
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG001853225700000X
NY009817-1225700000X
TXMT 113367225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist