Provider Demographics
NPI:1770651119
Name:BUZZELL, CHRISTINE RICHARDSON (MSPT)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:RICHARDSON
Last Name:BUZZELL
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11833 RIDGE PKWY
Mailing Address - Street 2:APT. 525
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80021-5078
Mailing Address - Country:US
Mailing Address - Phone:303-464-1234
Mailing Address - Fax:
Practice Address - Street 1:11833 RIDGE PKWY
Practice Address - Street 2:APT. 525
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80021-5078
Practice Address - Country:US
Practice Address - Phone:303-464-1234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6990225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist