Healthcare Provider Details

I. General information

NPI: 1225164353
Provider Name (Legal Business Name): GARLAND R HUFF ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/25/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3790 ASHFORD DUNWOODY RD NE
ATLANTA GA
30319-5104
US

IV. Provider business mailing address

2122 FRONT ROYAL CT
DUNWOODY GA
30338-5209
US

V. Phone/Fax

Practice location:
  • Phone: 770-936-2276
  • Fax: 770-936-2281
Mailing address:
  • Phone: 770-936-2276
  • Fax: 770-936-2281

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT000472
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: