Healthcare Provider Details

I. General information

NPI: 1437790854
Provider Name (Legal Business Name): TYLER JEFFREY HUFF DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2019
Last Update Date: 10/04/2022
Certification Date: 10/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 W MAIN ST STE B
LEXINGTON KY
40507-1340
US

IV. Provider business mailing address

1868 PLAUDIT PL STE B
LEXINGTON KY
40509-2429
US

V. Phone/Fax

Practice location:
  • Phone: 859-303-4312
  • Fax: 859-303-4314
Mailing address:
  • Phone: 859-264-0512
  • Fax: 859-264-0595

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number007831
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: