Individual
KATHY BUXTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1054 GREEN GABLES RD, EAST GULL LAKE, MN 56401-3167
(218) 829-8109
(218) 829-8109
Mailing address
1054 GREEN GABLES RD, EAST GULL LAKE, MN 56401-3167
(218) 829-8109
(218) 829-8109
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
—
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1174470001
PTAN
MN
Enumeration date
11/20/2015
Last updated
11/20/2015
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