Healthcare Provider Details

I. General information

NPI: 1265766190
Provider Name (Legal Business Name): DANA MARIE HUFF PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2009
Last Update Date: 09/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3503 CLEAR CREEK PL NE
RIO RANCHO NM
87144-3700
US

IV. Provider business mailing address

3503 CLEAR CREEK PL NE
RIO RANCHO NM
87144-3700
US

V. Phone/Fax

Practice location:
  • Phone: 505-238-0676
  • Fax:
Mailing address:
  • Phone: 505-238-0676
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number3430
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: