Individual
KATHARINE BUCY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1649 E PINE AVE, MERIDIAN, ID 83642-8135
(208) 917-2660
Mailing address
1649 E PINE AVE, MERIDIAN, ID 83642-8135
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
8185
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8185
PTA LICENSE
ID
Enumeration date
05/24/2022
Last updated
05/24/2022
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