Provider Demographics
NPI:1689260309
Name:HUEBENER, TERESA ALVETA (PT)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:ALVETA
Last Name:HUEBENER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9498 BLADENSBURG RD
Mailing Address - Street 2:
Mailing Address - City:OTTUMWA
Mailing Address - State:IA
Mailing Address - Zip Code:52501-9058
Mailing Address - Country:US
Mailing Address - Phone:641-226-9898
Mailing Address - Fax:
Practice Address - Street 1:3 PENNSYLVANIA PL
Practice Address - Street 2:
Practice Address - City:OTTUMWA
Practice Address - State:IA
Practice Address - Zip Code:52501-2165
Practice Address - Country:US
Practice Address - Phone:641-683-3372
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-16
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
01301OtherLICENSURE