Basic Information
| Provider Information | |||||||||
| NPI: | 1003882317 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HUFFMAN | ||||||||
| FirstName: | RICHARD | ||||||||
| MiddleName: | C | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10140 TRASK RIVER ROAD | ||||||||
| Address2: | |||||||||
| City: | TILLAMOOK | ||||||||
| State: | OR | ||||||||
| PostalCode: | 971419631 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5038428000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 911 COUNTRY CLUB #150 | ||||||||
| Address2: | OREGON SPINE PHYSICAL THERAPY | ||||||||
| City: | EUGENE | ||||||||
| State: | OR | ||||||||
| PostalCode: | 97405 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5416835139 | ||||||||
| FaxNumber: | 5416835783 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/27/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 0582 | OR | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.