Provider Demographics
NPI:1245265156
Name:HUFFER, KREG (DC)
Entity type:Individual
Prefix:DR
First Name:KREG
Middle Name:
Last Name:HUFFER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9468 GEYER RD.
Mailing Address - Street 2:
Mailing Address - City:WAPAKONETA
Mailing Address - State:OH
Mailing Address - Zip Code:45895
Mailing Address - Country:US
Mailing Address - Phone:937-596-6000
Mailing Address - Fax:
Practice Address - Street 1:307 S. MAIN ST
Practice Address - Street 2:
Practice Address - City:JACKSON CENTER
Practice Address - State:OH
Practice Address - Zip Code:45334
Practice Address - Country:US
Practice Address - Phone:937-596-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1028111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHHU0545161Medicare ID - Type Unspecified
OHT-48013Medicare UPIN