MEDICARE: BRENDA BUSS PTA

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	174400000X	Specialist	PT011175L	PA

General Provider Information

NPI Number	:	1598705048
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRENDA BUSS PTA

Provider Business Mailing Address
First Line	:	847 EASTON RD
Second Line	:	SUITE L700
City	:	WARRINGTON
State	:	PA
Zip	:	18976-2906
Country	:	US
Telephone Number	:	215-918-5610
Fax Number	:	215-918-5612

Provider Business Practice Location Address
First Line	:	847 EASTON RD
Second Line	:	SUITE L700
City	:	WARRINGTON
State	:	PA
Zip	:	18976-2906
Country	:	US
Telephone Number	:	215-918-5610
Fax Number	:	215-918-5612

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

Provider Enumeration Date	:	06/06/2006
Last Update Date	:	07/08/2007

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Directions to “ BRENDA BUSS PTA” Practice Location

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