Provider Demographics
NPI:1538414958
Name:HUFFMAN, JESSICA NOELLE (PT, DPT, OCS)
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:NOELLE
Last Name:HUFFMAN
Suffix:
Gender:F
Credentials:PT, DPT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5770 FLINTRIDGE DR STE 101
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-1896
Mailing Address - Country:US
Mailing Address - Phone:719-466-6800
Mailing Address - Fax:
Practice Address - Street 1:5770 FLINTRIDGE DR STE 101
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-1896
Practice Address - Country:US
Practice Address - Phone:719-466-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-23
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1220187225100000X
COPTL.0018082225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist