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Individual

DAVID CHRISTOPHER BUCKNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMT

Contact information

Practice address
111 HOMANS AVE, CLOSTER, NJ 07624-2728
(201) 784-5575
Mailing address
167 HUNGRY HOLLOW RD, CHESTNUT RIDGE, NY 10977-6155
(845) 248-9032

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
18KT01360000
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
18KT01360000
NJ DIVISION OF CONSUMER AFFAIRS - LMT
NJ
Enumeration date
10/10/2022
Last updated
10/10/2022
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