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1295164846
JEFFREY BUCKNAM
TRAVERSE CITY, MI
NPI
1295164846
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: MI 5201005105)
Enumeration Date
2013-11-04
Last Update Date
2013-11-04
Business Address
-- JEFFREY BUCKNAM
7711 GINGERWOOD DR
TRAVERSE CITY, MI 49685-9024
Phone number: 231-715-6122
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Mailing Address
-- JEFFREY BUCKNAM
7711 GINGERWOOD DR
TRAVERSE CITY, MI 49685-9024
Phone number:
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