Individual
MANDY D BUCKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPHT
Contact information
Practice address
200 W MAIN ST, JACKSON, TN 38301-6114
(731) 427-1528
(731) 423-4590
Mailing address
525 SMITH RD, LURAY, TN 38352-1789
(731) 983-0529
(731) 423-4590
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
17680
TN
Other
Enumeration date
01/16/2007
Last updated
07/08/2007
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