Provider Demographics
NPI:1215951843
Name:BUCHANAN THERAPY SERVICES, INC.
Entity type:Organization
Organization Name:BUCHANAN THERAPY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHYSICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTIE
Authorized Official - Middle Name:SHANTELL YATES
Authorized Official - Last Name:PLYMAL
Authorized Official - Suffix:
Authorized Official - Credentials:MPT, ATC, EMT
Authorized Official - Phone:276-935-5525
Mailing Address - Street 1:1103 H PLAZA DRIVE
Mailing Address - Street 2:
Mailing Address - City:GRUNDY
Mailing Address - State:VA
Mailing Address - Zip Code:24614
Mailing Address - Country:US
Mailing Address - Phone:276-935-5525
Mailing Address - Fax:276-935-5523
Practice Address - Street 1:1103 H PLAZA DRIVE
Practice Address - Street 2:
Practice Address - City:GRUNDY
Practice Address - State:VA
Practice Address - Zip Code:24614
Practice Address - Country:US
Practice Address - Phone:276-935-5525
Practice Address - Fax:276-935-5523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2015-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA261QP2000X261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810000838Medicaid
VA010093023Medicaid
VA496697Medicare Oscar/Certification