Basic Information
| Provider Information | |||||||||
| NPI: | 1114375508 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HUFFMAN | ||||||||
| FirstName: | OLIVIA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5400 S 56TH ST | ||||||||
| Address2: | STE 314 | ||||||||
| City: | LINCOLN | ||||||||
| State: | NE | ||||||||
| PostalCode: | 685161889 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5315003259 | ||||||||
| FaxNumber: | 5315004205 | ||||||||
| Practice Location | |||||||||
| Address1: | 5400 S 56TH ST | ||||||||
| Address2: | STE 314 | ||||||||
| City: | LINCOLN | ||||||||
| State: | NE | ||||||||
| PostalCode: | 685161889 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5315003259 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/26/2016 | ||||||||
| LastUpdateDate: | 06/16/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/16/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | NE | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225100000X | 11-05325 | KS | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.