Individual
MRS. ANITA A BUCKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
255 GREAT VALLEY PKWY, STE 140, MALVERN, PA 19355-1300
(610) 981-6411
(610) 981-6402
Mailing address
2 W 10TH ST, MARCUS HOOK, PA 19061-4513
(610) 859-8850
(610) 859-7876
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
40QA01101900
NJ
225100000X
Physical Therapist
Primary
PT-020453
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102567448-0001
—
PA
01
—
1750739
PA BLUE SHIELD
PA
Enumeration date
08/22/2006
Last updated
05/27/2011
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