Healthcare Provider Details

I. General information

NPI: 1699902478
Provider Name (Legal Business Name): ARLENE F BUENVENIDA PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2009
Last Update Date: 09/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 NORTH AVE
BATTLE CREEK MI
49017-3258
US

IV. Provider business mailing address

710 NORTH AVE
BATTLE CREEK MI
49017-3258
US

V. Phone/Fax

Practice location:
  • Phone: 269-788-3040
  • Fax: 269-788-3043
Mailing address:
  • Phone: 269-788-3040
  • Fax: 269-788-3043

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501007485
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: