Individual
GEORGIA M BUCKENROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
601 W BAIRD ST, WEST LIBERTY, OH 43357-9707
(937) 441-4234
Mailing address
601 W BAIRD ST, WEST LIBERTY, OH 43357-9707
(937) 441-4234
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN.153646-M-IV
OH
Other
Enumeration date
10/16/2015
Last updated
10/16/2015
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