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General NPI Number Information
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NPI Number | 1295902369
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Entity Type | Individual
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Provider Name | KENNETH HUEBNER PT
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Gender | Male
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Dates
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Enumeration Date | 05/08/2008
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Last Update Date | 05/08/2008
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Provider Practice Location Address
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Address Line | 1101 N CONGRESS AVE SUITE 208
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-3336
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Country | US
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Telephone | 561-736-0294
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Fax | 561-369-3544
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Provider Business Mailing Address
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Address Line | 8411 DYNASTY DR
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City | BOCA RATON
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State | FL
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Zip | 33433-6841
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Country | US
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Telephone | 561-213-5855
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Fax | 561-369-3544
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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 | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | PT 23455
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License Number State | FL
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