Individual
MR. LEONARD BUCKRIDGE HALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
CALIFORNIA MENS COLONY HIGHWAY 1, SAN LUIS OBISPO, CA 93409-0001
(805) 547-7900
Mailing address
4434 MATICH DR, RENO, NV 89502-6375
(775) 772-7466
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
20618
CA
Other
Enumeration date
08/26/2013
Last updated
08/26/2013
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