Provider Demographics
NPI:1518014976
Name:KUEBLER, CHRIS W (MPT,CSCS)
Entity Type:Individual
Prefix:
First Name:CHRIS
Middle Name:W
Last Name:KUEBLER
Suffix:
Gender:M
Credentials:MPT,CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:651 BIG BEND DR
Mailing Address - Street 2:
Mailing Address - City:WENTZVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63385-7401
Mailing Address - Country:US
Mailing Address - Phone:636-795-8414
Mailing Address - Fax:
Practice Address - Street 1:14 E MAIN ST
Practice Address - Street 2:SUITE 108
Practice Address - City:WENTZVILLE
Practice Address - State:MO
Practice Address - Zip Code:63385-1735
Practice Address - Country:US
Practice Address - Phone:636-327-6983
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2012-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003023398225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty