Organization
FORGING FORTITUDE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN CURTIS BUCKNER L.M.F.T. (THERAPIST)
(775) 530-0188
Entity
Organization
Contact information
Practice address
427 S MAIN ST, SUITE 305, CEDAR CITY, UT 84720-3955
(775) 530-0188
Mailing address
427 S MAIN ST, SUITE 305, CEDAR CITY, UT 84720-3955
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
7448466-3902
UT
Other
Enumeration date
12/19/2016
Last updated
12/19/2016
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