Individual
KIMBERLY BUCKNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11930 KINGSHEAD DR, FLORISSANT, MO 63033-7822
(314) 683-7266
Mailing address
11930 KINGSHEAD DR, FLORISSANT, MO 63033-7822
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
—
—
Other
Enumeration date
01/31/2025
Last updated
01/31/2025
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