Individual
KELLY K. BUCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
221 RACE ST APT 5, BAINBRIDGE, PA 17502-9013
(717) 736-0656
Mailing address
737 MARIETTA AVE APT 1, LANCASTER, PA 17603-3437
(717) 736-0656
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
225700000X
Massage Therapist
Primary
010616
PA
Other
Enumeration date
05/11/2017
Last updated
01/16/2024
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