=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891631602
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JARRETT MICHAEL HUBER
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/24/2026
-----------------------------------------------------
Last Update Date | 04/24/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 909 W 450 S
-----------------------------------------------------
City | SPRINGVILLE
-----------------------------------------------------
State | UT
-----------------------------------------------------
Zip | 84663-2292
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 602-877-3764
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 909 W 450 S
-----------------------------------------------------
City | SPRINGVILLE
-----------------------------------------------------
State | UT
-----------------------------------------------------
Zip | 84663-2292
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225800000X
-----------------------------------------------------
Taxonomy Name | Recreation Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------