Healthcare Provider Details

I. General information

NPI: 1255349155
Provider Name (Legal Business Name): RANDALL WILLIAM HUFFER DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 12/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9383 S OLD STATE RD
LEWIS CENTER OH
43035
US

IV. Provider business mailing address

9383 S OLD STATE RD
LEWIS CENTER OH
43035-8448
US

V. Phone/Fax

Practice location:
  • Phone: 614-846-2225
  • Fax: 614-846-8300
Mailing address:
  • Phone: 614-846-2225
  • Fax: 614-846-8300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3064
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: