Provider Demographics
NPI:1164570917
Name:HUFFER, REX D (DC)
Entity Type:Individual
Prefix:DR
First Name:REX
Middle Name:D
Last Name:HUFFER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 NORTH DETROIT STREET
Mailing Address - Street 2:PO BOX 752
Mailing Address - City:WEST LIBERTY
Mailing Address - State:OH
Mailing Address - Zip Code:43357
Mailing Address - Country:US
Mailing Address - Phone:937-465-2500
Mailing Address - Fax:937-465-2505
Practice Address - Street 1:128 NORTH DETROIT STREET
Practice Address - Street 2:
Practice Address - City:WEST LIBERTY
Practice Address - State:OH
Practice Address - Zip Code:43357
Practice Address - Country:US
Practice Address - Phone:937-465-2500
Practice Address - Fax:937-465-2505
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1321111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0604532Medicare ID - Type Unspecified
OHT468642Medicare UPIN