Provider Demographics
NPI:1700651460
Name:ELAM-HUFF, BRENDA LYNN (LPT)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:LYNN
Last Name:ELAM-HUFF
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7588 CENTRAL PARKE BLVD STE 207
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-6859
Mailing Address - Country:US
Mailing Address - Phone:513-770-0807
Mailing Address - Fax:513-770-0810
Practice Address - Street 1:7588 CENTRAL PARKE BLVD STE 207
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-6859
Practice Address - Country:US
Practice Address - Phone:513-770-0807
Practice Address - Fax:513-770-0810
Is Sole Proprietor?:No
Enumeration Date:2023-11-21
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT008363225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist