Provider Demographics
NPI:1801077524
Name:HUBER CHIROPRACTIC P.C.
Entity type:Organization
Organization Name:HUBER CHIROPRACTIC P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:HUBER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-476-2450
Mailing Address - Street 1:2945 BUFORD HWY
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-3451
Mailing Address - Country:US
Mailing Address - Phone:770-476-2450
Mailing Address - Fax:770-476-2450
Practice Address - Street 1:2945 BUFORD HWY
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-3451
Practice Address - Country:US
Practice Address - Phone:770-476-2450
Practice Address - Fax:770-476-2450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-21
Last Update Date:2007-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2888111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA35ZCJDGMedicare PIN