Provider Demographics
NPI:1932521861
Name:BUCHANAN, JANICE (PT)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:BUCHANAN
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 1:125 FILLMORE CIR
Mailing Address - Street 2:
Mailing Address - City:MT WASHINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40047-7811
Mailing Address - Country:US
Mailing Address - Phone:502-538-8078
Mailing Address - Fax:
Practice Address - Street 1:125 FILLMORE CIR
Practice Address - Street 2:
Practice Address - City:MT WASHINGTON
Practice Address - State:KY
Practice Address - Zip Code:40047-7811
Practice Address - Country:US
Practice Address - Phone:502-538-8078
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-12
Last Update Date:2014-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY002887225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist