Healthcare Provider Details

I. General information

NPI: 1811740434
Provider Name (Legal Business Name): MS. ALLY BOBBIE HUFFMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2024
Last Update Date: 04/12/2024
Certification Date: 04/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

540 5TH AVE
HUNTINGTON WV
25701-1908
US

IV. Provider business mailing address

540 5TH AVE
HUNTINGTON WV
25701-1908
US

V. Phone/Fax

Practice location:
  • Phone: 304-697-0022
  • Fax: 304-697-8556
Mailing address:
  • Phone: 304-697-0022
  • Fax: 304-697-8556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: