Individual
MICAH JB HUNT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, MPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2006022620
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37202071
BCBS KC
—
01
—
MA4370019
MEDICARE PTAN
MO
Enumeration date
06/14/2006
Last updated
01/10/2023
Update your record
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