Provider Demographics
NPI:1295386142
Name:HUFFORD, RYAN (LAC)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:HUFFORD
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8500 SE 160TH PL
Mailing Address - Street 2:
Mailing Address - City:SUMMERFIELD
Mailing Address - State:FL
Mailing Address - Zip Code:34491-5551
Mailing Address - Country:US
Mailing Address - Phone:352-657-0519
Mailing Address - Fax:
Practice Address - Street 1:8500 SE 160TH PL
Practice Address - Street 2:
Practice Address - City:SUMMERFIELD
Practice Address - State:FL
Practice Address - Zip Code:34491-5551
Practice Address - Country:US
Practice Address - Phone:352-657-0519
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-23
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP4094171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist