Individual
KRYSTLE BUCKNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1930 OAK ST, COLUMBIA, SC 29204-1025
(803) 463-1023
Mailing address
1930 OAK ST, COLUMBIA, SC 29204-1025
(803) 463-1023
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
34984
SC
Other
Enumeration date
06/13/2022
Last updated
06/13/2022
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