Individual
ROSALIND BUCKNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6696 LIVE OAK LN, DOUGLASVILLE, GA 30135-1624
(470) 330-2838
Mailing address
6696 LIVE OAK LN, DOUGLASVILLE, GA 30135-1624
(470) 330-2838
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
PHCP011023
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHCP011023
PRIVATE HOME CARE
GA
Enumeration date
02/25/2021
Last updated
02/25/2021
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