Provider Demographics
NPI:1689056483
Name:HAUBER, MICHAEL WESLEY (DPT)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:WESLEY
Last Name:HAUBER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:335 NW BARRY RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64155-2740
Mailing Address - Country:US
Mailing Address - Phone:816-468-5278
Mailing Address - Fax:816-285-5278
Practice Address - Street 1:12728 STATE LINE RD
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66209
Practice Address - Country:US
Practice Address - Phone:816-941-2550
Practice Address - Fax:816-941-2520
Is Sole Proprietor?:No
Enumeration Date:2015-06-29
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015017586225100000X
KS1105534225100000X
MO2015027170225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist