Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic |
NPI | 1043689722 |
---|---|
Provider Name | Paige Buffington |
First Address | Bridgeton, MO 63044-2525 |
Second Address | Bridgeton, MO 63044-2525 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2015 |
Last Update Date | 23/09/2015 |