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General NPI Number Information
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NPI Number | 1023555166
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Entity Type | Individual
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Provider Name | AUSTIN HUBBARD D.C
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Gender | Male
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Dates
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Enumeration Date | 01/27/2017
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Last Update Date | 01/29/2024
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Provider Practice Location Address
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Address Line | 295 N BROAD ST
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City | CARLINVILLE
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State | IL
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Zip | 62626-1301
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Country | US
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Telephone | 217-854-8211
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Fax | 217-854-3636
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Provider Business Mailing Address
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Address Line | 295 N BROAD ST
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City | CARLINVILLE
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State | IL
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Zip | 62626-1301
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Country | US
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Telephone | 217-854-8211
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Fax | 217-854-3636
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2017002310
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 038.013450
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License Number State | IL
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