Individual
DR. KEVIN W BUECKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
653 36TH ST SW, WYOMING, MI 49509-4004
(616) 530-0085
(616) 531-5029
Mailing address
515 NORTH SE, CALEDONIA, MI 49316-9407
(616) 891-5105
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
KB004130
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2117924
—
MI
01
—
950 D1 5107
BCBS PROVIDER ID
MI
01
—
P52560
BCN PROVIDER ID
MI
Enumeration date
03/16/2007
Last updated
07/09/2007
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