Individual
REBECCA BUCKLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
114 TOLER AVE, FAYETTEVILLE, WV 25840-1120
(304) 574-1219
Mailing address
114 TOLER AVE, FAYETTEVILLE, WV 25840-1120
(304) 574-1219
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
03/02/2021
Last updated
03/02/2021
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