Individual
KELLY BUCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
1444 N HUMBOLDT AVE APT 3, MILWAUKEE, WI 53202-2843
(414) 906-0632
Mailing address
1444 N HUMBOLDT AVE APT 3, MILWAUKEE, WI 53202-2843
(414) 906-0632
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
12577
WI
Other
Enumeration date
11/12/2014
Last updated
11/12/2014
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