Individual
MRS. MITZI BUCK
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
1050 E ARMY POST ROAD, SUITE E & F, DES MOINES, IA 50315
(515) 953-5817
(515) 953-1085
Mailing address
8602 WESTOWN PARKWAY, #1701, WEST DES MOINES, IA 50266
(515) 987-6747
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
03827
IA
225100000X
Physical Therapist
49201552401
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03827
STATE LICENSE
IA
01
—
04285
BCBS
IA
05
—
0665737
—
IA
01
—
49201552401
STATE LICENSE
UT
Enumeration date
03/30/2006
Last updated
07/08/2007
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