Individual
MRS. JOHANNA LYDIA BUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, PT
Contact information
Practice address
400 CRATER LAKE AVE, MEDFORD, OR 97504-6808
(541) 613-6505
(541) 770-9212
Mailing address
400 CRATER LAKE AVE, MEDFORD, OR 97504-6808
(541) 613-6505
(541) 770-9212
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
05897
OR
Other
Enumeration date
01/20/2007
Last updated
02/27/2019
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