MEDICARE: ASHLYN NICOLE BUCHAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225200000X	Physical Therapy Assistant

General Provider Information

NPI Number	:	1437816980
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLYN NICOLE BUCHAN

Provider Business Mailing Address
First Line	:	405 US HIGHWAY 1 APT 201
Second Line	:
City	:	NORTH PALM BEACH
State	:	FL
Zip	:	33408-5521
Country	:	US
Telephone Number	:	772-349-5451
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 AVENUE OF THE CHAMPIONS STE 100
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418-3615
Country	:	US
Telephone Number	:	561-223-3872
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/19/2021
Last Update Date	:	11/19/2021

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