Provider Demographics
NPI:1891302709
Name:HUBER, JOYCE
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:
Last Name:HUBER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 102
Mailing Address - Street 2:
Mailing Address - City:NORTH STAR
Mailing Address - State:OH
Mailing Address - Zip Code:45350-0102
Mailing Address - Country:US
Mailing Address - Phone:937-564-6419
Mailing Address - Fax:
Practice Address - Street 1:45 CONNIE LANE
Practice Address - Street 2:
Practice Address - City:NORTH STAR
Practice Address - State:OH
Practice Address - Zip Code:45350
Practice Address - Country:US
Practice Address - Phone:937-564-6419
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-24
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care