Healthcare Provider Details

I. General information

NPI: 1083028823
Provider Name (Legal Business Name): KEVIN HUFF DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2014
Last Update Date: 03/31/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1730 SAVANNAH HWY
CHARLESTON SC
29407-6255
US

IV. Provider business mailing address

790 REMINGTON BLVD
BOLINGBROOK IL
60440-4909
US

V. Phone/Fax

Practice location:
  • Phone: 843-763-4115
  • Fax: 843-766-3240
Mailing address:
  • Phone: 630-296-2223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number7377
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: