Individual
MARK BUCKLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
711 AVIGNON DR, RIDGELAND, MS 39157-5120
(601) 605-6777
(601) 605-8869
Mailing address
711 AVIGNON DR, RIDGELAND, MS 39157-5120
(601) 605-6777
(601) 605-8869
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT3708
MS
Other
Enumeration date
03/26/2008
Last updated
03/26/2008
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