Individual
KYLE KELLEY BUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
800 E 28TH ST, MINNEAPOLIS, MN 55407-3723
(612) 863-4000
Mailing address
2633 PLEASANT AVE APT 203, MINNEAPOLIS, MN 55408-1451
(507) 319-1903
Taxonomy
Speciality
Code
Description
License number
State
225XN1300X
Neurorehabilitation Occupational Therapist
Primary
106101
MN
Other
Enumeration date
02/03/2020
Last updated
02/03/2020
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