Provider Demographics
NPI:1669994737
Name:BUUS, TAMI JO (PT)
Entity type:Individual
Prefix:
First Name:TAMI
Middle Name:JO
Last Name:BUUS
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 1:19820 341ST ST
Mailing Address - Street 2:
Mailing Address - City:TAYLORS FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:55084-2700
Mailing Address - Country:US
Mailing Address - Phone:651-734-5558
Mailing Address - Fax:
Practice Address - Street 1:265 GRIFFIN ST E
Practice Address - Street 2:
Practice Address - City:AMERY
Practice Address - State:WI
Practice Address - Zip Code:54001-1439
Practice Address - Country:US
Practice Address - Phone:715-268-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-11
Last Update Date:2017-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI13899-24225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist