Provider Demographics
NPI:1407957525
Name:HUBER, KRIS (DC)
Entity Type:Individual
Prefix:DR
First Name:KRIS
Middle Name:
Last Name:HUBER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 COUNTY ROAD 42 W
Mailing Address - Street 2:STE 4
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-6945
Mailing Address - Country:US
Mailing Address - Phone:952-894-9888
Mailing Address - Fax:952-894-2154
Practice Address - Street 1:2500 COUNTY ROAD 42 W
Practice Address - Street 2:STE 4
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-6945
Practice Address - Country:US
Practice Address - Phone:952-894-9888
Practice Address - Fax:952-894-2154
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN002323111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN23907HUOtherBCBS
MN718315100Medicaid