Provider Demographics
NPI:1306622931
Name:MCCABE, JUSTIN J (DCEP)
Entity type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:J
Last Name:MCCABE
Suffix:
Gender:M
Credentials:DCEP
Other - Prefix:
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Mailing Address - Street 1:4202 SHOAL LOOP SE APT 209
Mailing Address - Street 2:
Mailing Address - City:MANDAN
Mailing Address - State:ND
Mailing Address - Zip Code:58554-6422
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7500 UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58504-9652
Practice Address - Country:US
Practice Address - Phone:701-355-5198
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-08
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise Physiologist