Provider Demographics
NPI:1659324614
Name:HUFFMAN, DARYL D (PT)
Entity Type:Individual
Prefix:MR
First Name:DARYL
Middle Name:D
Last Name:HUFFMAN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 W MORRIS BLVD
Mailing Address - Street 2:SUITE 170
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37813-2283
Mailing Address - Country:US
Mailing Address - Phone:423-585-8488
Mailing Address - Fax:423-585-8428
Practice Address - Street 1:420 W MORRIS BLVD
Practice Address - Street 2:SUITE 170
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37813-2283
Practice Address - Country:US
Practice Address - Phone:423-585-8488
Practice Address - Fax:423-585-8428
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5147225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3645822Medicare ID - Type Unspecified