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General NPI Number Information
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NPI Number | 1003920406
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Entity Type | Individual
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Provider Name | HANS CALVIN HUMBERGER P.T.
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Gender | Male
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Dates
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Enumeration Date | 08/19/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2255 CENTER STREET SUITE 104
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City | CHATTANOOGA
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State | TN
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Zip | 37421-2500
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Country | US
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Telephone | 423-855-0745
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Fax | 423-855-7898
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Provider Business Mailing Address
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Address Line | 2255 CENTER STREET SUITE 104
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City | CHATTANOOGA
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State | TN
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Zip | 37421-2500
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Country | US
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Telephone | 423-855-0745
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Fax | 423-855-7898
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 756
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1114
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License Number State | GA
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