Provider Demographics
NPI:1952175572
Name:BUYER, EMILY ROSE (DPT)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:ROSE
Last Name:BUYER
Suffix:
Gender:
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1242 W SIX SHOOTER ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:ID
Mailing Address - Zip Code:83644-6205
Mailing Address - Country:US
Mailing Address - Phone:925-639-2870
Mailing Address - Fax:
Practice Address - Street 1:3277 E LOUISE DR STE 410
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-9360
Practice Address - Country:US
Practice Address - Phone:208-489-5800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-14
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID8952225100000X
AZ32492225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist