Healthcare Provider Details

I. General information

NPI: 1073434536
Provider Name (Legal Business Name): CAITLIN BUENING PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

606 E CHERRY ST RM 100
SPRINGFIELD MO
65897-3402
US

IV. Provider business mailing address

901 S NATIONAL AVE
SPRINGFIELD MO
65897-0001
US

V. Phone/Fax

Practice location:
  • Phone: 417-836-4451
  • Fax: 417-836-3032
Mailing address:
  • Phone: 417-836-4451
  • Fax: 417-836-3032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2004015713
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: