Healthcare Provider Details

I. General information

NPI: 1245559038
Provider Name (Legal Business Name): LISA MARIE HUFFMAN PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MRS. LISA MARIE HUFFMAN

II. Dates (important events)

Enumeration Date: 05/19/2010
Last Update Date: 02/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 E STATE ST
COLUMBUS OH
43215-4312
US

IV. Provider business mailing address

270 E STATE ST
COLUMBUS OH
43215-4312
US

V. Phone/Fax

Practice location:
  • Phone: 614-365-5000
  • Fax:
Mailing address:
  • Phone: 614-365-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number09394
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: