Individual
MRS. ANNETTE SUSAN BUCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
49 ANGEL LANE, TULAROSA, NM 88532
(505) 585-3556
Mailing address
49 ANGEL LANE, TULAROSA, NM 88532
(505) 585-3556
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A0502
NM
Other
Enumeration date
02/04/2008
Last updated
02/04/2008
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