Individual
KRISTEN BROADWAY BUCHNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
42ND MEDICAL GROUP, 300 S. TWINING STREET, MONTGOMERY, AL 36112
(334) 953-4415
(334) 953-6646
Mailing address
300 TWINING ST BLDG 760, MONTGOMERY, AL 36112-6027
(334) 953-4415
(334) 953-6646
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PTH3856
AL
2251P0200X
Pediatric Physical Therapist
Primary
PTH3856
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
515-33661
BLUE CROSS BLUE SHEILD
AL
01
—
51533661
BCBS
AL
Enumeration date
07/12/2006
Last updated
04/26/2018
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