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1154951259
JESSE BUCKNER
MEDFORD, OR
NPI
1154951259
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
Enumeration Date
2020-01-17
Last Update Date
2020-04-04
Business Address
JESSE BUCKNER COTA/L
834 S FRONT ST
MEDFORD, OR 97502-2726
Phone number: 541-664-7400
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Mailing Address
JESSE BUCKNER COTA/L
560 NE F ST STE A #114
GRANTS PASS, OR 97526
Phone number:
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