Individual
MRS. MICHELLE LEE BUZZAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
2366 NW LAKESIDE PL, BEND, OR 97701-3535
(541) 382-4843
Mailing address
2366 NW LAKESIDE PL, BEND, OR 97701-3535
(541) 382-4843
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
981181
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
981181
OT LICENSE
OR
Enumeration date
01/29/2009
Last updated
01/29/2009
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