Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251G0304X | Physical Therapist - Geriatrics | 0236 | SD |
N | 2251N0400X | Physical Therapist - Neurology | 0236 | SD |
N | 2251P0200X | Physical Therapist - Pediatrics | 0236 | SD |
N | 2251S0007X | Physical Therapist - Sports | 0236 | SD |
Y | 2251X0800X | Physical Therapist - Orthopedic | 0236 | SD |
NPI | 1144518895 |
---|---|
Provider Name | Lisa Mary Huber |
First Address | Yankton, SD 57078-5370 |
Second Address | Yankton, SD 57078-5370 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2011 |
Last Update Date | 28/09/2012 |