Healthcare Provider Details

I. General information

NPI: 1548155047
Provider Name (Legal Business Name): BOBBIE HUFFMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2025
Last Update Date: 06/12/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 CROSSING LN STE 207
LEXINGTON VA
24450-6354
US

IV. Provider business mailing address

16 CHUBBYS LN
FAIRFIELD VA
24435-2418
US

V. Phone/Fax

Practice location:
  • Phone: 540-464-5800
  • Fax:
Mailing address:
  • Phone: 540-414-2388
  • Fax: 540-414-2388

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number0019020210
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: