Provider Demographics
NPI:1912025255
Name:BUFFINGTON, ANNE MICHELLE
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:MICHELLE
Last Name:BUFFINGTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2350 BUHNE ST STE C
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501-3205
Mailing Address - Country:US
Mailing Address - Phone:707-668-4284
Mailing Address - Fax:707-268-8264
Practice Address - Street 1:2350 BUHNE ST STE C
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-3205
Practice Address - Country:US
Practice Address - Phone:707-668-4284
Practice Address - Fax:707-268-8264
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT246370225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOPT246370Medicare ID - Type UnspecifiedPHYSICAL THERAPY