Individual
CHEYENNE ASHLEY-SUSAN BUKSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
124 VASSAL CT, CONWAY, SC 29526-1145
(406) 794-2651
Mailing address
124 VASSAL CT, CONWAY, SC 29526-1145
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
06/08/2020
Last updated
06/08/2020
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