Individual
LAWRENCE EDWARD BUCKMAN III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
C PED.
Contact information
Practice address
5823 E RIVERSIDE BLVD, ROCKFORD, IL 61114-4963
(815) 654-1900
(815) 282-9567
Mailing address
5823 E RIVERSIDE BLVD, ROCKFORD, IL 61114-4963
(815) 654-1900
(815) 282-9567
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
IL
Other
Enumeration date
04/11/2007
Last updated
07/08/2007
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