Individual
MR. JERRY HUBER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
743 SPIRIT 40 PARK DR, STE 121, CHESTERFIELD, MO 63005-1129
(314) 220-4000
Mailing address
604 SPRING MEADOW DR, WENTZVILLE, MO 63385-3447
(314) 220-4044
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
NA
MO
Other
Enumeration date
11/06/2007
Last updated
11/06/2007
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