Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 354 | CT |
Y | 175F00000X | Naturopath | 312 | CT |
NPI | 1093989840 |
---|---|
Provider Name | Mitchell Hubsher |
First Address | Ridgefield, CT 06877-1202 |
Second Address | Ridgefield, CT 06877-1202 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2008 |
Last Update Date | 14/04/2008 |