Individual
SHANNON MARIE BUCKMASTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1495 S BLACK RIDGE DR STE A270, ST GEORGE, UT 84770-7174
(503) 329-1696
Mailing address
5794 S AMBER RIDGE DR, SAINT GEORGE, UT 84790-1948
(503) 329-1696
(503) 925-9733
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3055AT
OR
Other
Enumeration date
09/07/2005
Last updated
09/02/2022
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