Individual
KELLI SUZANNE BUCKNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
16888 HARVARD AVE, CLEVELAND, OH 44128-2208
(330) 323-3060
Mailing address
13438 SEBE DR, MARSHALLVILLE, OH 44645-9767
(303) 278-6263
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34.010614
OH
Other
Enumeration date
07/06/2010
Last updated
09/01/2021
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