Healthcare Provider Details

I. General information

NPI: 1235227869
Provider Name (Legal Business Name): COLLEEN POWERS HUFF PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1375 SUTTER ST SUITE 210
SAN FRANCISCO CA
94109-5438
US

IV. Provider business mailing address

1375 SUTTER ST SUITE 210
SAN FRANCISCO CA
94109-5438
US

V. Phone/Fax

Practice location:
  • Phone: 415-202-8788
  • Fax: 415-202-8797
Mailing address:
  • Phone: 415-202-8788
  • Fax: 415-202-8797

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number10313
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: