Provider Demographics
NPI:1861008161
Name:HUFFER, KREG DILLON
Entity Type:Individual
Prefix:DR
First Name:KREG
Middle Name:DILLON
Last Name:HUFFER
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 1:2156 DERBY DR
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43040-8143
Mailing Address - Country:US
Mailing Address - Phone:937-638-4909
Mailing Address - Fax:
Practice Address - Street 1:6631 COMMERCE PKWY STE R
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-3239
Practice Address - Country:US
Practice Address - Phone:614-401-2021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-22
Last Update Date:2022-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH04712111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor