Individual
MR. KEVIN R HUBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICAL THERAPIST
Contact information
Practice address
512 SAYBROOK RD, MIDDLETOWN, CT 06457-4788
(860) 343-5997
(860) 343-6042
Mailing address
465 WOLCOTT RD, WOLCOTT, CT 06716-2613
(203) 879-0107
(203) 879-0206
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
006452
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080006452CT01
BLUE CROSS BLUE SHIELD
CT
01
—
2671991
AETNA ID NUMBER
CT
01
—
2V4932
PHS HEALTHNET PROVIDER ID
CT
01
—
6404276
UHC PROVIDER ID
CT
01
—
761899
CONNECTICARE
CT
01
—
P3665127
OXFORD PROVIDER ID
CT
Enumeration date
01/11/2007
Last updated
10/03/2016
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