Provider Demographics
NPI:1003395245
Name:BUESCHER, MATTHEW DOUGLAS (OTD, OTR/L)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:DOUGLAS
Last Name:BUESCHER
Suffix:
Gender:M
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:MATT
Other - Middle Name:DOUGLAS
Other - Last Name:BUESCHER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTD, OTR/L
Mailing Address - Street 1:6000 LILLIBRIDGE ST APT 9
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-3567
Mailing Address - Country:US
Mailing Address - Phone:402-770-5816
Mailing Address - Fax:
Practice Address - Street 1:1001 SOUTH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68502-2251
Practice Address - Country:US
Practice Address - Phone:402-441-7101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-08
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2118225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist