Healthcare Provider Details

I. General information

NPI: 1871741322
Provider Name (Legal Business Name): HUXFORD CHIROPRACTIC CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2008
Last Update Date: 09/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

706 ELK ST
ROCK SPRINGS WY
82901-5247
US

IV. Provider business mailing address

706 ELK STREET
ROCK SPRINGS WY
82901
US

V. Phone/Fax

Practice location:
  • Phone: 307-362-5352
  • Fax: 307-382-7662
Mailing address:
  • Phone: 307-362-5352
  • Fax: 307-382-7662

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number431
License Number StateWY

VIII. Authorized Official

Name: DR. FLOYD PATRICK HUXFORD
Title or Position: CHIEF EXECUATIVE OFFICER
Credential: D.C
Phone: 307-362-5352