Healthcare Provider Details

I. General information

NPI: 1417579848
Provider Name (Legal Business Name): ANDREW HUFFMAN DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2020
Last Update Date: 05/20/2020
Certification Date: 05/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4130 PIONEER WOODS DR STE 3
LINCOLN NE
68506-7552
US

IV. Provider business mailing address

4130 PIONEER WOODS DR STE 3
LINCOLN NE
68506-7552
US

V. Phone/Fax

Practice location:
  • Phone: 402-261-6841
  • Fax: 402-261-6843
Mailing address:
  • Phone: 402-261-6841
  • Fax: 402-261-6843

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2049
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: