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General NPI Number Information
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NPI Number | 1255631636
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Entity Type | Organization
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Legal Business Name | CORE INTEGRATED HEALTH AND CHIROPRACTIC PLLC
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Dates
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Enumeration Date | 11/01/2010
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Last Update Date | 12/02/2010
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Provider Practice Location Address
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Address Line | 224 CARLTON RD
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22902-5972
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Country | US
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Telephone | 434-466-4875
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Fax |
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Provider Business Mailing Address
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Address Line | 410 7 1/2 ST SW
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22903-3823
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. TATE HUFFMAN
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Credential | D.C.
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Telephone | 434-466-4875
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 0104556824
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License Number State | VA
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