Provider Demographics
NPI:1154156495
Name:HUFF, BURT RODRIQUEZ JR (DC)
Entity type:Individual
Prefix:DR
First Name:BURT
Middle Name:RODRIQUEZ
Last Name:HUFF
Suffix:JR
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 1:2765 S MARKET ST STE 105
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-1305
Mailing Address - Country:US
Mailing Address - Phone:480-963-1363
Mailing Address - Fax:
Practice Address - Street 1:2765 S MARKET ST STE 105
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-1305
Practice Address - Country:US
Practice Address - Phone:480-963-1363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-05
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ9338111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor