Healthcare Provider Details

I. General information

NPI: 1790811933
Provider Name (Legal Business Name): CHARLES ESTON HUFF IV P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1316 ISLAND CLUB DR UNIT D
CHARLESTON SC
29492-8251
US

IV. Provider business mailing address

1316 ISLAND CLUB DR UNIT D
CHARLESTON SC
29492-8251
US

V. Phone/Fax

Practice location:
  • Phone: 843-830-0490
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5089
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: