Healthcare Provider Details

I. General information

NPI: 1598424251
Provider Name (Legal Business Name): DANIEL HUFFMAN OTR/L
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2021
Last Update Date: 12/09/2021
Certification Date: 12/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL CENTER DR
CLARKSBURG WV
26301
US

IV. Provider business mailing address

1 MEDICAL CENTER DR
CLARKSBURG WV
26301
US

V. Phone/Fax

Practice location:
  • Phone: 304-623-3461
  • Fax:
Mailing address:
  • Phone: 304-623-3461
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number2017
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: