Provider Demographics
NPI:1922118819
Name:SCHUBERT, MICHELLE
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:SCHUBERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8785 E 25TH AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80238-2786
Mailing Address - Country:US
Mailing Address - Phone:303-818-8863
Mailing Address - Fax:
Practice Address - Street 1:3102 S PARKER RD
Practice Address - Street 2:SUITE A - 15
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-3176
Practice Address - Country:US
Practice Address - Phone:303-338-8598
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO7637OtherLICENSE #