Provider Demographics
NPI:1487931739
Name:BUCHANAN, TIFFANY SUZANNE (CMT)
Entity type:Individual
Prefix:MS
First Name:TIFFANY
Middle Name:SUZANNE
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 S 4TH ST
Mailing Address - Street 2:
Mailing Address - City:GETTYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17325-2001
Mailing Address - Country:US
Mailing Address - Phone:717-926-7043
Mailing Address - Fax:
Practice Address - Street 1:40 V TWIN DR
Practice Address - Street 2:ROOM 2512
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-7875
Practice Address - Country:US
Practice Address - Phone:717-339-2033
Practice Address - Fax:717-851-5957
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-14
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG003713171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor