Healthcare Provider Details
I. General information
NPI: 1932200375
Provider Name (Legal Business Name): JOHN DANIEL HUFFMAN DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/26/2006
Last Update Date: 03/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2030 E 38TH ST
ERIE PA
16510-3607
US
IV. Provider business mailing address
2030 E 38TH ST
ERIE PA
16510-3607
US
V. Phone/Fax
- Phone: 814-825-2129
- Fax: 814-825-3134
- Phone: 814-825-2129
- Fax: 814-825-3134
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | DC009968 |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | OH3663 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: