Individual
DR. KENNETH PATRICK BUCKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1175 MADISON AVE, MANKATO, MN 56001-5227
(507) 625-1791
(507) 625-9262
Mailing address
1175 MADISON AVE, MANKATO, MN 56001-5227
(507) 625-1791
(507) 625-9262
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
120201
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
120201
PHARMACIST LICENSE
MN
Enumeration date
05/03/2020
Last updated
05/03/2020
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