Provider Demographics
NPI:1942428941
Name:BUCHANAN, STEPHEN JAY (PT, DPT, OCS, CHT)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:JAY
Last Name:BUCHANAN
Suffix:
Gender:M
Credentials:PT, DPT, OCS, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 RUNNING CREEK WAY
Mailing Address - Street 2:BUILDING B, SUITE 150
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-5563
Mailing Address - Country:US
Mailing Address - Phone:801-766-4244
Mailing Address - Fax:801-766-4245
Practice Address - Street 1:3300 RUNNING CREEK WAY
Practice Address - Street 2:BUILDING B, SUITE 150
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-5563
Practice Address - Country:US
Practice Address - Phone:801-766-4244
Practice Address - Fax:801-766-4245
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5161134-24012251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic