Individual
KILEY BUCHANAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8100 NORTHLAND DR, BLOOMINGTON, MN 55431-4800
(952) 931-8742
(952) 831-1626
Mailing address
8170 33RD AVE S # MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
363A00000X
Physician Assistant
Primary
14934
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/07/2017
Last updated
06/19/2024
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