Provider Demographics
NPI:1649361205
Name:HUBER, ANITA J (DC)
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:J
Last Name:HUBER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 BUS. HWY. 61 SOUTH
Mailing Address - Street 2:SUITE D
Mailing Address - City:BOWLING GREEN
Mailing Address - State:MO
Mailing Address - Zip Code:63334
Mailing Address - Country:US
Mailing Address - Phone:573-324-6012
Mailing Address - Fax:573-324-6014
Practice Address - Street 1:1420 BUS. HWY. 61 SOUTH
Practice Address - Street 2:SUITE D
Practice Address - City:BOWLING GREEN
Practice Address - State:MO
Practice Address - Zip Code:63334
Practice Address - Country:US
Practice Address - Phone:573-324-6012
Practice Address - Fax:573-324-6014
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001006912111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO144836OtherBLUE CROSS BLUE SHIELD
MO466698OtherHEALTHLINK
MO617979OtherUNITED HEALTHCARE
MO466698OtherHEALTHLINK