Individual
PAUL SHANNON HUFFMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1695 MESQUITE AVE, SUITE 114, LAKE HAVASU CITY, AZ 86403-5647
(928) 453-6808
(928) 453-8485
Mailing address
1695 MESQUITE AVE, SUITE 114, LAKE HAVASU CITY, AZ 86403-5647
(928) 453-6808
(928) 453-8485
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5112
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1Z1452
HEALTH NET
AZ
01
—
350055273
RAILROAD MEDICARE
AZ
01
—
AZ0935770
BLUE CROSS BLUE SHIELD
AZ
Enumeration date
08/15/2006
Last updated
07/08/2007
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