Provider Demographics
NPI:1366540262
Name:KUBLIN, AMY L (ATC)
Entity type:Individual
Prefix:MS
First Name:AMY
Middle Name:L
Last Name:KUBLIN
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4057 E HAWTHORNE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-1021
Mailing Address - Country:US
Mailing Address - Phone:520-323-2030
Mailing Address - Fax:520-323-2030
Practice Address - Street 1:4057 E HAWTHORNE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-1021
Practice Address - Country:US
Practice Address - Phone:520-323-2030
Practice Address - Fax:520-323-2030
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ00652255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer