MEDICARE: JOSHUA HUBERT DPT

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	225100000X	Physical Therapist	PT018205	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	561758	OTHER	PA	BLUE SHIELD GRP NUMBER

General Provider Information

NPI Number	:	1710058425
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSHUA HUBERT DPT

Provider Business Mailing Address
First Line	:	213 E MAIN ST REAR
Second Line	:
City	:	EVANS CITY
State	:	PA
Zip	:	16033-1219
Country	:	US
Telephone Number	:	724-432-3035
Fax Number	:

Provider Business Practice Location Address
First Line	:	213 E MAIN ST
Second Line	:
City	:	EVANS CITY
State	:	PA
Zip	:	16033-1219
Country	:	US
Telephone Number	:	412-551-9576
Fax Number	:

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

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	08/14/2019

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