Healthcare Provider Details

I. General information

NPI: 1023089455
Provider Name (Legal Business Name): ALLEN J HUFFMAN DC, PT
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 GARDEN CITY DR STE 104
LANDOVER MD
20785-2210
US

IV. Provider business mailing address

11418 LIVINGSTON RD
FT WASHINGTON MD
20744-5145
US

V. Phone/Fax

Practice location:
  • Phone: 301-577-1115
  • Fax: 301-577-6487
Mailing address:
  • Phone: 240-766-0300
  • Fax: 240-766-0301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberS02014
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number0104555561
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: