MEDICARE: JANET L. HUBER O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	OD00002028	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598768731
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANET L. HUBER O.D.

Provider Business Mailing Address
First Line	:	1022 W IVY AVE
Second Line	:
City	:	MOSES LAKE
State	:	WA
Zip	:	98837-4107
Country	:	US
Telephone Number	:	509-765-7845
Fax Number	:	509-765-5192

Provider Business Practice Location Address
First Line	:	1022 W IVY AVE
Second Line	:
City	:	MOSES LAKE
State	:	WA
Zip	:	98837-4107
Country	:	US
Telephone Number	:	509-765-7845
Fax Number	:	509-765-5192

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	03/24/2011

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