Provider Demographics
NPI:1649716069
Name:BUCHER, WESTON (ATC)
Entity type:Individual
Prefix:
First Name:WESTON
Middle Name:
Last Name:BUCHER
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:PO BOX 549
Mailing Address - Street 2:
Mailing Address - City:DOUGLASS
Mailing Address - State:KS
Mailing Address - Zip Code:67039-0549
Mailing Address - Country:US
Mailing Address - Phone:316-204-7980
Mailing Address - Fax:
Practice Address - Street 1:1437 N ROCHESTER ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67203-2647
Practice Address - Country:US
Practice Address - Phone:316-973-6107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-09
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS24-003162255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer