MEDICARE: DR. READE L. HUBERT D.C.

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	111N00000X	Chiropractor	2301007408	MI

General Provider Information

NPI Number	:	1770507956
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. READE L. HUBERT D.C.

Provider Business Mailing Address
First Line	:	113 S 12TH ST
Second Line	:
City	:	ESCANABA
State	:	MI
Zip	:	49829-3448
Country	:	US
Telephone Number	:	906-786-1428
Fax Number	:

Provider Business Practice Location Address
First Line	:	113 S 12TH ST
Second Line	:
City	:	ESCANABA
State	:	MI
Zip	:	49829-3448
Country	:	US
Telephone Number	:	906-786-1428
Fax Number	:

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

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	07/08/2007

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