Individual
ALICIA BUCKNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.A. - C
Contact information
Practice address
2250 W SOUTHERN AVE, STE 102, MESA, AZ 85202-4736
(480) 835-5547
(480) 962-0106
Mailing address
2250 W SOUTHERN AVE, STE 102, MESA, AZ 85202-4736
(480) 835-5547
(480) 962-0106
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
6405
AZ
Other
Enumeration date
04/24/2014
Last updated
11/07/2016
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