Provider Demographics
NPI:1215172200
Name:BUETTNER, STEPHANIE (LMT)
Entity type:Individual
Prefix:MISS
First Name:STEPHANIE
Middle Name:
Last Name:BUETTNER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9070 E. DESERT COVE DR.
Mailing Address - Street 2:SUITE B-106
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-6228
Mailing Address - Country:US
Mailing Address - Phone:480-390-9730
Mailing Address - Fax:480-483-4655
Practice Address - Street 1:9070 E. DESERT COVE DR.
Practice Address - Street 2:SUITE B-106
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-6228
Practice Address - Country:US
Practice Address - Phone:480-390-9730
Practice Address - Fax:480-483-4655
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-05
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMT-03380P225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist