Individual
LESLIE BUCKNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1485 INTERNATIONAL PKWY, HEATHROW, FL 32746-5303
(800) 798-6035
Mailing address
17853 SANTIAGO BLVD # 107-233, VILLA PARK, CA 92861-4113
(946) 878-6807
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1139
CA
Other
Enumeration date
12/17/2007
Last updated
12/17/2007
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