Provider Demographics
NPI:1811137359
Name:HUINKER, DUSTIN ALLEN (DPT)
Entity type:Individual
Prefix:MR
First Name:DUSTIN
Middle Name:ALLEN
Last Name:HUINKER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 COLLINS RD NE MS: 154 100
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52498-0505
Mailing Address - Country:US
Mailing Address - Phone:319-295-8899
Mailing Address - Fax:
Practice Address - Street 1:1908 N 203RD ST
Practice Address - Street 2:SUITE #3
Practice Address - City:ELKHORN
Practice Address - State:NE
Practice Address - Zip Code:68022-2889
Practice Address - Country:US
Practice Address - Phone:402-289-5013
Practice Address - Fax:402-289-5018
Is Sole Proprietor?:No
Enumeration Date:2009-02-24
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0042612251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE099709OtherMEDICARE GROUP #
NE412135956 68022A002OtherTRIWEST
NE39960OtherBLUE CROSS BLUE SHILEDS
NE216812OtherCOVENTRY
NE10025112300Medicaid
NE099709OtherMEDICARE GROUP #