Provider Demographics
NPI:1407836281
Name:HUBER, CHRISTINE P (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:P
Last Name:HUBER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 RIDGEHILL RD
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MA
Mailing Address - Zip Code:02021-1627
Mailing Address - Country:US
Mailing Address - Phone:781-713-4714
Mailing Address - Fax:781-713-4715
Practice Address - Street 1:12 REVERE ST
Practice Address - Street 2:#1
Practice Address - City:CANTON
Practice Address - State:MA
Practice Address - Zip Code:02021-2971
Practice Address - Country:US
Practice Address - Phone:781-713-4714
Practice Address - Fax:781-713-4715
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2009-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1623111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY45263Medicare ID - Type Unspecified
MA1613367Medicare ID - Type Unspecified