Individual
CANDICE J BUKEVICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSPT
Contact information
Practice address
190 WELLES ST, FORTY FORT, PA 18704-4968
(570) 714-4171
(570) 714-4188
Mailing address
610 WYOMING AVE, KINGSTON, PA 18704-3702
(570) 288-5441
(570) 288-5842
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT007548L
PA
Other
Enumeration date
07/18/2006
Last updated
07/08/2007
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