Provider Demographics
NPI:1366683195
Name:HUFFMAN, ANDY CODY (DC)
Entity Type:Individual
Prefix:
First Name:ANDY
Middle Name:CODY
Last Name:HUFFMAN
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 1:6060 TELEGRAPH RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63129-4762
Mailing Address - Country:US
Mailing Address - Phone:314-846-6700
Mailing Address - Fax:314-846-8840
Practice Address - Street 1:6060 TELEGRAPH RD
Practice Address - Street 2:SUITE A
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63129-4762
Practice Address - Country:US
Practice Address - Phone:314-846-6700
Practice Address - Fax:314-846-8840
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-06
Last Update Date:2009-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009000493111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor