Individual
WHITNEY ELAINE BUCKLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LDN
Contact information
Practice address
303 NW 11TH ST, FAIRFIELD, IL 62837-1203
(618) 847-8326
Mailing address
694 COUNTY ROAD 200 E, ELLERY, IL 62833-4358
(618) 445-1321
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164.005535
IL
Other
Enumeration date
01/30/2015
Last updated
01/30/2015
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