Healthcare Provider Details

I. General information

NPI: 1225336688
Provider Name (Legal Business Name): HUFFMAN CHIROPRACTIC, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2011
Last Update Date: 06/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9101 S WESTERN AVE SUITE 112
OKLAHOMA CITY OK
73139-2758
US

IV. Provider business mailing address

8315 NW 16TH ST
OKLAHOMA CITY OK
73127-3011
US

V. Phone/Fax

Practice location:
  • Phone: 405-735-2744
  • Fax:
Mailing address:
  • Phone: 405-620-4136
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4017
License Number StateOK

VIII. Authorized Official

Name: RICHARD LOUIS HUFFMAN
Title or Position: DOCTOR
Credential: D.C.
Phone: 405-789-1954