Individual
JESSICA BUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1165 MONARCH ST, LEXINGTON, KY 40513-1979
(859) 823-5055
Mailing address
2504 SUNGALE CT, LEXINGTON, KY 40513-1478
(413) 335-8503
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
135073
KY
Other
Enumeration date
06/13/2019
Last updated
06/13/2019
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