MEDICARE: JILL M HUBER RMT, CNMT

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	174400000X	Specialist	MT0006156	CO

General Provider Information

NPI Number	:	1790129203
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JILL M HUBER RMT, CNMT

Provider Business Mailing Address
First Line	:	320 N LIMIT ST
Second Line	:	SUITE 109
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80904-4524
Country	:	US
Telephone Number	:	719-494-4276
Fax Number	:

Provider Business Practice Location Address
First Line	:	3585 VAN TEYLINGEN DR
Second Line	:	SUITE H
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80917-4875
Country	:	US
Telephone Number	:	719-494-4276
Fax Number	:

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

Provider Enumeration Date	:	04/26/2013
Last Update Date	:	04/26/2013

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