Healthcare Provider Details

I. General information

NPI: 1477752327
Provider Name (Legal Business Name): AMELIA LOUISE BUECHE D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2007
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

869 ROBINWOOD CT
TRAVERSE CITY MI
49686-4316
US

IV. Provider business mailing address

344 W 13TH ST
TRAVERSE CITY MI
49684-4012
US

V. Phone/Fax

Practice location:
  • Phone: 989-327-7668
  • Fax:
Mailing address:
  • Phone: 989-327-7668
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number5101017185
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: