MEDICARE: KINDELAN HUBER

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	225X00000X	Occupational Therapist	OC015002	PA

General Provider Information

NPI Number	:	1407380488
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KINDELAN HUBER

Provider Business Mailing Address
First Line	:	913 RIVER OAKS DR
Second Line	:
City	:	ASPINWALL
State	:	PA
Zip	:	15215-1616
Country	:	US
Telephone Number	:	330-571-1791
Fax Number	:

Provider Business Practice Location Address
First Line	:	410 E 4TH AVE
Second Line	:
City	:	TARENTUM
State	:	PA
Zip	:	15084-1810
Country	:	US
Telephone Number	:	724-594-0676
Fax Number	:

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

Provider Enumeration Date	:	04/17/2017
Last Update Date	:	04/17/2017

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