Provider Demographics
NPI:1003882317
Name:HUFFMAN, RICHARD C (PT)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:C
Last Name:HUFFMAN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10140 TRASK RIVER ROAD
Mailing Address - Street 2:
Mailing Address - City:TILLAMOOK
Mailing Address - State:OR
Mailing Address - Zip Code:97141-9631
Mailing Address - Country:US
Mailing Address - Phone:503-842-8000
Mailing Address - Fax:
Practice Address - Street 1:911 COUNTRY CLUB #150
Practice Address - Street 2:OREGON SPINE PHYSICAL THERAPY
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405
Practice Address - Country:US
Practice Address - Phone:541-683-5139
Practice Address - Fax:541-683-5783
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0582225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist