Basic Information
| Provider Information | |||||||||
| NPI: | 1487965919 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BUZZI | ||||||||
| FirstName: | JEANNE | ||||||||
| MiddleName: | MARIE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | PTA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 155 HERITAGE WOODS DRIVE | ||||||||
| Address2: | |||||||||
| City: | COPLEY | ||||||||
| State: | OH | ||||||||
| PostalCode: | 44321 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3306660980 | ||||||||
| FaxNumber: | 3306663835 | ||||||||
| Practice Location | |||||||||
| Address1: | 155 HERITAGE WOODS DR | ||||||||
| Address2: | |||||||||
| City: | COPLEY | ||||||||
| State: | OH | ||||||||
| PostalCode: | 443211398 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3306660980 | ||||||||
| FaxNumber: | 3306663835 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2010 | ||||||||
| LastUpdateDate: | 06/30/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225200000X | 5918 | OH | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.