Provider Demographics
NPI:1982728358
Name:BUSKIRK, LEANN (OTR)
Entity Type:Individual
Prefix:
First Name:LEANN
Middle Name:
Last Name:BUSKIRK
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6434 N COUNTY ROAD 940 W
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:IN
Mailing Address - Zip Code:47356-9717
Mailing Address - Country:US
Mailing Address - Phone:765-620-8400
Mailing Address - Fax:765-779-4010
Practice Address - Street 1:2021 SOUTH MEMORIAL DRIVE
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:IN
Practice Address - Zip Code:47362
Practice Address - Country:US
Practice Address - Phone:765-593-9355
Practice Address - Fax:765-593-9466
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2011-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31002723A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist