Provider Demographics
NPI:1053858969
Name:BUSSJAEGER, CATHERINE D (PT)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:D
Last Name:BUSSJAEGER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6929 KNOLLCREST DR
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:TN
Mailing Address - Zip Code:37341-9471
Mailing Address - Country:US
Mailing Address - Phone:423-991-8252
Mailing Address - Fax:
Practice Address - Street 1:6929 KNOLLCREST DR
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:TN
Practice Address - Zip Code:37341-9471
Practice Address - Country:US
Practice Address - Phone:423-991-8252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-30
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPT0000006638225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist