Provider Demographics
NPI:1558045302
Name:HUFFMAN, COLTEN MICHAEL
Entity Type:Individual
Prefix:
First Name:COLTEN
Middle Name:MICHAEL
Last Name:HUFFMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 HOMEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44312-1217
Mailing Address - Country:US
Mailing Address - Phone:330-217-9011
Mailing Address - Fax:
Practice Address - Street 1:3148 GRILL RD
Practice Address - Street 2:
Practice Address - City:NEW FRANKLIN
Practice Address - State:OH
Practice Address - Zip Code:44216-9381
Practice Address - Country:US
Practice Address - Phone:330-701-7765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider