Provider Demographics
NPI:1164516241
Name:BUSBY, CHERYL A (PT)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:A
Last Name:BUSBY
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:PO BOX 184
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:LA
Mailing Address - Zip Code:70462-0184
Mailing Address - Country:US
Mailing Address - Phone:225-414-0550
Mailing Address - Fax:225-228-4256
Practice Address - Street 1:31545 HIGHWAY 22 STE A
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:LA
Practice Address - Zip Code:70462-7405
Practice Address - Country:US
Practice Address - Phone:225-414-0550
Practice Address - Fax:225-228-4256
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPT03894225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2000713OtherAETNA
LA1677485Medicaid
LA6400001OtherUNITED HEALTHCARE
LA2000713OtherAETNA
LA6400001OtherUNITED HEALTHCARE