Healthcare Provider Details

I. General information

NPI: 1104903194
Provider Name (Legal Business Name): RODNEY DALE HUFFSTUTLER D.C. NP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 09/24/2020
Certification Date: 09/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1021 MONTGOMERY HWY STE 201
VESTAVIA HILLS AL
35216-2805
US

IV. Provider business mailing address

4200 COLONNADE PKWY
BIRMINGHAM AL
35243-2342
US

V. Phone/Fax

Practice location:
  • Phone: 205-971-1925
  • Fax: 205-971-1926
Mailing address:
  • Phone: 205-971-3356
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1587
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-149036
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: