Provider Demographics
NPI:1740605187
Name:HUFF, JUSTIN NICHOLAS (DPT)
Entity Type:Individual
Prefix:
First Name:JUSTIN
Middle Name:NICHOLAS
Last Name:HUFF
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9701 FOREST LAKE RD
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:PA
Mailing Address - Zip Code:18801-8262
Mailing Address - Country:US
Mailing Address - Phone:570-396-0106
Mailing Address - Fax:
Practice Address - Street 1:2805 OLD POST RD
Practice Address - Street 2:SUITE 110
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17110-3675
Practice Address - Country:US
Practice Address - Phone:717-635-2030
Practice Address - Fax:717-635-2029
Is Sole Proprietor?:No
Enumeration Date:2014-02-21
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT023407225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist