Organization
SKINSATIONS DERMATHERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JIM J HUBER JR. (OWNER)
(765) 377-7039
Entity
Organization
Contact information
Practice address
746 NORTHSIDE CT, CONNERSVILLE, IN 47331-2583
(765) 377-7039
Mailing address
746 NORTHSIDE CT, CONNERSVILLE, IN 47331-2583
(765) 265-9832
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1053583690
GROUP NPI
—
Enumeration date
06/19/2008
Last updated
01/15/2015
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