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1811020373
THOMAS MICHAEL BUCKLES
MODESTO, CA
NPI
1811020373
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2007-03-13
Last Update Date
2007-07-08
Business Address
-- THOMAS MICHAEL BUCKLES
920 12TH ST
MODESTO, CA 95354-2320
Phone number: 209-558-4081
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Mailing Address
-- THOMAS MICHAEL BUCKLES
920 12TH ST
MODESTO, CA 95354-2320
Phone number: 209-558-4081
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