Individual
JACK BUCHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7 WESTOWNE ST STE 403, LIBERTY, MO 64068-1166
(816) 407-1754
Mailing address
118 N 2ND ST STE 200, SAINT CHARLES, MO 63301-2894
(636) 224-1210
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
04/24/2019
Last updated
04/24/2019
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