Provider Demographics
NPI:1568636132
Name:HUNTSBERGER, JAMES ROBERT II (LMT)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ROBERT
Last Name:HUNTSBERGER
Suffix:II
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:526 CLARK RD
Mailing Address - Street 2:
Mailing Address - City:PROSPECT
Mailing Address - State:ME
Mailing Address - Zip Code:04981-3418
Mailing Address - Country:US
Mailing Address - Phone:207-322-3079
Mailing Address - Fax:
Practice Address - Street 1:102A MAIN ST
Practice Address - Street 2:DTA CENTER
Practice Address - City:ELLSWORTH
Practice Address - State:ME
Practice Address - Zip Code:04605
Practice Address - Country:US
Practice Address - Phone:207-322-3079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-15
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMT2383172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist