Individual
MARLON J BUCKLEY SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
800 ZORN AVE, LOUISVILLE, KY 40206-1433
(502) 287-6172
Mailing address
109 AZALEA CT, CLARKSVILLE, TN 37042-3495
(615) 838-2938
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LSW0000011022
TN
Other
Enumeration date
06/29/2019
Last updated
06/29/2019
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