Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 7377 | SC |
NPI | 1083028823 |
---|---|
Provider Name | Kevin Huff |
First Address | Bolingbrook, IL 60440-4909 |
Second Address | Charleston, SC 29407-6255 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2014 |
Last Update Date | 31/03/2017 |