Provider Demographics
NPI:1679740971
Name:HUFFMAN, SANDRA KAY (MPT)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:KAY
Last Name:HUFFMAN
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6925 S LINDBERGH BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63125-4200
Mailing Address - Country:US
Mailing Address - Phone:314-894-8616
Mailing Address - Fax:314-894-8633
Practice Address - Street 1:6925 S LINDBERGH BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63125-4200
Practice Address - Country:US
Practice Address - Phone:314-894-8616
Practice Address - Fax:314-894-8633
Is Sole Proprietor?:No
Enumeration Date:2008-05-15
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20001545722251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8T4781OtherBCBS
TX8G5014Medicare PIN