Provider Demographics
NPI:1427238096
Name:BUEHRE, SCOTT T (ATC)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:T
Last Name:BUEHRE
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 1 BOX 70E
Mailing Address - Street 2:
Mailing Address - City:CYRIL
Mailing Address - State:OK
Mailing Address - Zip Code:73029-9715
Mailing Address - Country:US
Mailing Address - Phone:580-464-3256
Mailing Address - Fax:
Practice Address - Street 1:5202 W GORE BLVD
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-5840
Practice Address - Country:US
Practice Address - Phone:580-483-6207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-12
Last Update Date:2007-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKAT2102255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer