Basic Information
| Provider Information | |||||||||
| NPI: | 1477040533 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HUEBNER | ||||||||
| FirstName: | BRITTANY | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 123 LOG TRAIL DR APT B | ||||||||
| Address2: | |||||||||
| City: | BALLWIN | ||||||||
| State: | MO | ||||||||
| PostalCode: | 630113764 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3146065065 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5400 EXECUTIVE CENTRE PKWY | ||||||||
| Address2: | |||||||||
| City: | SAINT PETERS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 633762594 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6369227600 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/15/2018 | ||||||||
| LastUpdateDate: | 04/15/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 2018003418 | MO | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.