Provider Demographics
NPI:1932420346
Name:BUOL, SUSAN KATHARINA (ATC)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:KATHARINA
Last Name:BUOL
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:236 ORCHARD HILL DR
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29170-3075
Mailing Address - Country:US
Mailing Address - Phone:803-358-0220
Mailing Address - Fax:
Practice Address - Street 1:236 ORCHARD HILL DR
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29170-3075
Practice Address - Country:US
Practice Address - Phone:803-358-0220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-21
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10622255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer