Provider Demographics
NPI:1073694238
Name:HUFFER CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:HUFFER CHIROPRACTIC, INC.
Other - Org Name:HUFFER CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KREG
Authorized Official - Middle Name:DILLON
Authorized Official - Last Name:HUFFER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:937-638-4909
Mailing Address - Street 1:307 S. MAIN ST.
Mailing Address - Street 2:P.O. BOX 647
Mailing Address - City:JACKSON CENTER
Mailing Address - State:OH
Mailing Address - Zip Code:45334
Mailing Address - Country:US
Mailing Address - Phone:937-596-6000
Mailing Address - Fax:937-596-5109
Practice Address - Street 1:307 S. MAIN ST.
Practice Address - Street 2:
Practice Address - City:JACKSON CENTER
Practice Address - State:OH
Practice Address - Zip Code:45334
Practice Address - Country:US
Practice Address - Phone:937-596-6000
Practice Address - Fax:937-596-5109
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OPTIMAL HEALTH HOLDINGS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-17
Last Update Date:2022-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHHU9286031Medicare ID - Type Unspecified