Provider Demographics
NPI:1679766877
Name:HUFMANN, ROBERT JASON (PTA)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:JASON
Last Name:HUFMANN
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3213 LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63111-1702
Mailing Address - Country:US
Mailing Address - Phone:314-255-7195
Mailing Address - Fax:
Practice Address - Street 1:3213 LIBERTY ST
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63111-1702
Practice Address - Country:US
Practice Address - Phone:314-255-7195
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-21
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007025052225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant