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General NPI Number Information
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NPI Number | 1396567624
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Entity Type | Organization
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Legal Business Name | BUFF BABIES, LLC
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Dates
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Enumeration Date | 10/28/2024
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 3341 W SUNNYSIDE AVE APT 1B
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City | CHICAGO
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State | IL
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Zip | 60625-8843
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Country | US
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Telephone | 630-397-8604
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Fax |
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Provider Business Mailing Address
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Address Line | 3341 W SUNNYSIDE AVE APT 1B
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City | CHICAGO
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State | IL
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Zip | 60625-8843
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TIFFANY BESANA
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Credential | DPT
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Telephone | 630-397-8604
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number |
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License Number State |
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