Provider Demographics
NPI:1124346507
Name:RUBSAM, DAVID L (PT, OCS, ASTYM)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:L
Last Name:RUBSAM
Suffix:
Gender:M
Credentials:PT, OCS, ASTYM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:999 44TH ST
Mailing Address - Street 2:SUITE 10,000
Mailing Address - City:MARION
Mailing Address - State:IA
Mailing Address - Zip Code:52302-3846
Mailing Address - Country:US
Mailing Address - Phone:319-373-7311
Mailing Address - Fax:319-373-7313
Practice Address - Street 1:999 44TH ST
Practice Address - Street 2:SUITE 10,000
Practice Address - City:MARION
Practice Address - State:IA
Practice Address - Zip Code:52302-3846
Practice Address - Country:US
Practice Address - Phone:319-373-7311
Practice Address - Fax:319-373-7313
Is Sole Proprietor?:No
Enumeration Date:2010-05-11
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01609225XP0019X
IA1609225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
I17220001Medicare PIN