Healthcare Provider Details

I. General information

NPI: 1003008491
Provider Name (Legal Business Name): CHRISTINE D BUCHANAN PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2007
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2190 HIGHWAY 85 N
NICEVILLE FL
32578-1045
US

IV. Provider business mailing address

903 BAY BREEZE CV
NICEVILLE FL
32578-2591
US

V. Phone/Fax

Practice location:
  • Phone: 850-678-4131
  • Fax:
Mailing address:
  • Phone: 850-496-6942
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number23334
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: