Provider Demographics
NPI:1710024237
Name:HUBER-WILLIS, JOBETH KATHLEEN (PT, MPT)
Entity Type:Individual
Prefix:MRS
First Name:JOBETH
Middle Name:KATHLEEN
Last Name:HUBER-WILLIS
Suffix:
Gender:F
Credentials:PT, MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4610 BEALL BLVD
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606-8421
Mailing Address - Country:US
Mailing Address - Phone:325-698-9273
Mailing Address - Fax:325-793-3463
Practice Address - Street 1:4601 HARTFORD ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79605-4603
Practice Address - Country:US
Practice Address - Phone:325-793-3565
Practice Address - Fax:325-793-3463
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2011-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11305992251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics