Provider Demographics
NPI:1679192694
Name:HUEBNER, JAMIE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:HUEBNER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:848 E KIOWA ST APT B1
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-3555
Mailing Address - Country:US
Mailing Address - Phone:618-792-2137
Mailing Address - Fax:
Practice Address - Street 1:175 S UNION BLVD STE 250
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80910-3125
Practice Address - Country:US
Practice Address - Phone:719-365-1876
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-09
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist