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Organization

DERMATHERIC LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JAMES J HUBER JR. (OWNER)
(765) 827-4000
Entity
Organization

Contact information

Practice address
822 E MAIN ST, RICHMOND, IN 47374-4331
(765) 965-7546
Mailing address
748 NORTHSIDE CT, CONNERSVILLE, IN 47331-2583
(765) 827-4000
(765) 827-4000

Taxonomy

Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1669452959
INDIVIDUAL NPI #
IN
Enumeration date
01/04/2007
Last updated
11/20/2007
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