Provider Demographics
NPI:1598891822
Name:BUENZLI, ERIN L (MS, ATC)
Entity type:Individual
Prefix:MS
First Name:ERIN
Middle Name:L
Last Name:BUENZLI
Suffix:
Gender:F
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 E BOLDT WAY
Mailing Address - Street 2:SPC 10
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54911-5690
Mailing Address - Country:US
Mailing Address - Phone:920-832-7190
Mailing Address - Fax:920-832-7488
Practice Address - Street 1:711 E BOLDT WAY
Practice Address - Street 2:SPC 10
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54911-5690
Practice Address - Country:US
Practice Address - Phone:920-832-7190
Practice Address - Fax:920-832-7488
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7-0392255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer