Individual
MR. VINCENT CHARLES BUZZAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
715 KENSINGTON AVE, SUITE 18, MISSOULA, MT 59801-5769
(406) 549-4646
Mailing address
715 KENSINGTON AVE, SUITE 18, MISSOULA, MT 59801-5769
(406) 549-4646
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
110
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03-00089-0
MT. STATEFUND(WORKERSCOMP
MT
05
—
34-1835
—
MT
01
—
6035-0
BLUECROSSBLUESHIELD,MT
MT
Enumeration date
05/22/2007
Last updated
01/12/2011
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