Provider Demographics
NPI:1992418073
Name:HUFFMAN, TRACEY (DC)
Entity type:Individual
Prefix:DR
First Name:TRACEY
Middle Name:
Last Name:HUFFMAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 FIELD ST APT C118
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30263-2080
Mailing Address - Country:US
Mailing Address - Phone:540-798-2814
Mailing Address - Fax:
Practice Address - Street 1:8 FRANKLIN RD STE A
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30263-1312
Practice Address - Country:US
Practice Address - Phone:404-654-3413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-03
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR010776111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor