Provider Demographics
NPI:1376961201
Name:BUCHNA, COURTNEY
Entity type:Individual
Prefix:MS
First Name:COURTNEY
Middle Name:
Last Name:BUCHNA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12350 ANGLING RD
Mailing Address - Street 2:
Mailing Address - City:EDINBORO
Mailing Address - State:PA
Mailing Address - Zip Code:16412-1312
Mailing Address - Country:US
Mailing Address - Phone:814-881-5864
Mailing Address - Fax:
Practice Address - Street 1:120 W ALLEGHENY RD
Practice Address - Street 2:SUITE 2
Practice Address - City:IMPERIAL
Practice Address - State:PA
Practice Address - Zip Code:15126-9788
Practice Address - Country:US
Practice Address - Phone:724-695-5300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-28
Last Update Date:2014-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG008706225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist