Provider Demographics
NPI:1174228753
Name:HUFFER, TYLER EDWARD (DC)
Entity type:Individual
Prefix:DR
First Name:TYLER
Middle Name:EDWARD
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 1:307 SOUTH MAIN STREET
Mailing Address - Street 2:PO BOX 647
Mailing Address - City:JACKSON CENTER
Mailing Address - State:OH
Mailing Address - Zip Code:45334
Mailing Address - Country:US
Mailing Address - Phone:937-596-6000
Mailing Address - Fax:937-596-5109
Practice Address - Street 1:307 SOUTH MAIN STREET
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:937-596-5109
Is Sole Proprietor?:No
Enumeration Date:2023-04-03
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHDC-05253111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor