Provider Demographics
NPI:1205388816
Name:BUUCK, ARIANNA NICHOLE (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:ARIANNA
Middle Name:NICHOLE
Last Name:BUUCK
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:MS
Other - First Name:ARIANNA
Other - Middle Name:NICHOLE
Other - Last Name:KUMMER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:1575 HIGHWAY 34 E STE B
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265-2401
Mailing Address - Country:US
Mailing Address - Phone:770-683-5042
Mailing Address - Fax:678-877-8444
Practice Address - Street 1:1575 HIGHWAY 34 E STE B
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-2401
Practice Address - Country:US
Practice Address - Phone:770-683-5042
Practice Address - Fax:678-877-8444
Is Sole Proprietor?:No
Enumeration Date:2016-10-30
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT012630225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist