Individual
ALLEN MICHAEL BUKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-8400
Mailing address
105 ASHTON AVE, MOUNT JULIET, TN 37122-1516
(218) 821-1975
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
11897
TN
Other
Enumeration date
01/15/2019
Last updated
01/15/2019
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