Provider Demographics
NPI:1073665303
Name:BUZARD, JOAN E (PT)
Entity Type:Individual
Prefix:MS
First Name:JOAN
Middle Name:E
Last Name:BUZARD
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:JOAN
Other - Middle Name:E
Other - Last Name:KENDALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:340 S BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67202-4304
Mailing Address - Country:US
Mailing Address - Phone:316-267-5437
Mailing Address - Fax:316-267-5444
Practice Address - Street 1:340 S BROADWAY ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67202-4304
Practice Address - Country:US
Practice Address - Phone:316-267-5437
Practice Address - Fax:316-267-5444
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-01482225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist