Provider Demographics
NPI:1871741322
Name:HUXFORD CHIROPRACTIC CLINIC
Entity type:Organization
Organization Name:HUXFORD CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUATIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:FLOYD
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:HUXFORD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:307-362-5352
Mailing Address - Street 1:706 ELK STREET
Mailing Address - Street 2:
Mailing Address - City:ROCK SPRINGS
Mailing Address - State:WY
Mailing Address - Zip Code:82901
Mailing Address - Country:US
Mailing Address - Phone:307-362-5352
Mailing Address - Fax:307-382-7662
Practice Address - Street 1:706 ELK ST
Practice Address - Street 2:
Practice Address - City:ROCK SPRINGS
Practice Address - State:WY
Practice Address - Zip Code:82901-5247
Practice Address - Country:US
Practice Address - Phone:307-362-5352
Practice Address - Fax:307-382-7662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-08
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY431261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY4671022Medicare UPIN