Healthcare Provider Details

I. General information

NPI: 1427549203
Provider Name (Legal Business Name): KAITLYN BUSS PT, DPT, MHA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAITLYN ISELBORN

II. Dates (important events)

Enumeration Date: 05/29/2018
Last Update Date: 08/26/2024
Certification Date: 08/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 TOWER RD NE STE 140
MARIETTA GA
30060-9412
US

IV. Provider business mailing address

1200 CORPORATE DR STE 400
HOOVER AL
35242-5424
US

V. Phone/Fax

Practice location:
  • Phone: 770-419-9437
  • Fax:
Mailing address:
  • Phone: 866-518-0283
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTH11985
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT33545
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: