Individual
CHARLES ALLEN HUBBARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
513 E CAPRI DR, BONNE TERRE, MO 63628-9331
(573) 358-7356
(573) 358-7356
Mailing address
513 E CAPRI DR, BONNE TERRE, MO 63628-9331
(573) 358-7356
(573) 358-7356
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
R0530
MO
Other
Enumeration date
08/13/2007
Last updated
08/13/2007
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