Individual
MISTY D BUCKALOO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2502 CROSSROADS DR, SUITE B, ARDMORE, OK 73401-2503
(580) 226-4800
Mailing address
2502 CROSSROADS DR, SUITE B, ARDMORE, OK 73401-2503
(580) 226-4800
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/09/2010
Last updated
11/09/2010
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