Provider Demographics
NPI:1366593766
Name:BUETER, CYNTHIA LYNN (PT)
Entity type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:LYNN
Last Name:BUETER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6012 CAROL ST
Mailing Address - Street 2:
Mailing Address - City:HOUSE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:63051-1432
Mailing Address - Country:US
Mailing Address - Phone:314-471-9898
Mailing Address - Fax:
Practice Address - Street 1:4625 LINDELL BLVD
Practice Address - Street 2:SUITE 510
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63108-3729
Practice Address - Country:US
Practice Address - Phone:314-367-7450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2007-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004018039225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist