Healthcare Provider Details

I. General information

NPI: 1225292071
Provider Name (Legal Business Name): ROSEMARIE ANN BUZA DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2008
Last Update Date: 07/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14073 MANCHESTER RD
MANCHESTER MO
63011-4513
US

IV. Provider business mailing address

14073 MANCHESTER RD
MANCHESTER MO
63011-4513
US

V. Phone/Fax

Practice location:
  • Phone: 636-227-8500
  • Fax:
Mailing address:
  • Phone: 636-227-8500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2008018540
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: