Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT33545 | FL |
N | 2251S0007X | Physical Therapist - Sports | 33545 | FL |
N | 2251X0800X | Physical Therapist - Orthopedic | 33545 | FL |
NPI | 1427549203 |
---|---|
Provider Name | Dr. Kaitlyn Iselborn Buss |
First Address | Jacksonville, FL 32207-8856 |
Second Address | Jacksonville, FL 32207-8856 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2018 |
Last Update Date | 13/10/2021 |