Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | ||
Y | 222Z00000X | Podiatrist | ||
N | 225000000X | Orthotic Fitter |
NPI | 1629430541 |
---|---|
Provider Name | Kelsey Huber |
First Address | Aberdeen, SD 57401-0300 |
Second Address | Aberdeen, SD 57401-0300 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2016 |
Last Update Date | 22/03/2016 |