Individual
JEFFREY TRENT BUCKELEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
42746 HWY 25, VINCENT, AL 35178
(205) 642-9274
Mailing address
PO BOX 429, VINCENT, AL 35178-3600
(205) 642-9274
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10803
AL
Other
Enumeration date
04/10/2020
Last updated
04/10/2020
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